RF-12-1135Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 175019 Permit Number: RF -6 -12 -1135
Scheduled Inspection Date: August 08, 2012
Inspector: Bruhn, Norman
Owner: LARA, ISAAC
Job Address: 3 NE 110 Street
Miami Shores, FL 33161 -7043
Project: <NONE>
Contractor: HOME OWNER
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Repair Roof
Phone Number
Parcel Number 1121360040310
Building Department Comments
REPLACE ROOF TILES
Inspector Comments
Passed-
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
August 07, 2012
For Inspections please call: (305)762 -4949
Page 7 of 33
(i2,k2-t\■Q
Miami Shores Village RECEIVE
Building Department JUN 212012
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 BY:
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: 1141 e- /10
City: Miami Shores County: Miami bade Zip: 33 1
FoliolParcel #: f l 2-1,3 0 0 0 4 0 3 10
FBC 20 iLn
Permit No. I — 135
Master Permit No.
ROOFING
Is the Building Historically Designated: Yes NO Flood
OWNER: Name (Fee Simple Titleholder): J— SA 1.4 1, Phone#118) 1//7 ° J TZ
Address:3 RJ ® S
City: r(e 15( rnx e4c 0 9..�S Stag mil. o- zip: 33 D l¢
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: h A% V2-- Phone #:
Address:
City: State: Zip:
Qualifier Name: Phone#:
State Certification or Registration #: Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
a
Value of Work for this Permit: $ Q d 0 . ® Square/Linear Footage of Work:
Type of Work: DAddition DAlteration ONew C pair/Replace
Description of Work: OW IA e.t. LOOF 71 L E-S
Lik
ODemolition
Color thru tile:
***** ** ***u** ** ****** * ***** *** ****** ** eeon********* ** ** *** * ****** ******* **** **** **
Submittal Fee $ Permit Fee $ 7 CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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 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 - MAX. 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 . t be approved and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of --, 20 (Q, by 1 S AAC.• LAO—N- ,
who is personally known to me or whQ
.�`� \ if91Aia ean oath.
As identify �Q`��S
1%2*. . /
3�d61Zp16
21
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Signature
Contractor
The foregoing instrument was acknowledged before me this
day of , 20 _, by
who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
* * * * *** * * ** * * ** * * * * * * * * * * * * * * *** ******************************************* * ** * * *** **** * * * * * * * * * * * * ** * * * **
APPROVED BY ; o fans Examiner Zoning
Structural Review
(Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09)
Clerk
!PERMIT #: 12 -- ( 135
Miami Shores Villa .e
APPROVED BY DATE
ZONING DEPT
BLDG DEPT
SUBJECT r'O Cc:MPI.J JCE WI (i-i All FEDERAL
HIGH - VELOCITY HURRICANE ZONES
RECEIVED
JUN 212012
P P.
STATE AND errioridalkaltling 10
High VeiodtrHnrri arre-Zane Unifom
Front.
Section A (General Information),
Master Permit No. Process No
Contractor's Name
Job Address
ROOF CATEGORY
❑ Low Slope ❑ Mechanically Fastened Tile Mortar /Adhesive Set Tile
❑ Asphaltic ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes
Shingles
❑ Prescriptive BUR -RAS 150
ROOF TYPE
O New Roof ❑ Reroofing ❑ Recovering ErRepair ❑ Maintenance
ROOF SYSTEM INFORMATION
Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF)
N Section B (Roof Plan)
oof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow
and overflow drains. Include dimensions of sections and levels, clearly
ensions of elevated pressure zones and location of • - a • its
1
u)
6
2010 FLORIDA BUILDING CODE — RESIDENTIAL
k= o Nl o 1r= t\o\)SE.
Ad 01
SECTION R4402.13
HIGH VELOCITY 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 govem 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. c--9f' 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. 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 adjacent units of roofing to be performed.
4. 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.
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.
Overflow 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.
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.
Owner /Agent's ignature Date
Revised on 7/9/2009 LD
hz_
Contractor Signature Date
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNER BUILDER DISCLOSURE STATEMENT
NAME: L S i J C , t"�l'a- DATE: 6 // P) 1 2
ADDRESS: 3 Al / /10
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the State of Florida, F.S 489.103(7).
And I have read and understood the following disclosure statement, which entitles me to work as my own contractor; I further
understand that I as the owner must appear in person to complete all applications.
State Law requires construction to be done by a licensed contractor. You have applied for a permit under an exception to the law. The
exemption allows you, as the owner of your property, to act as your own contractor even though you do not have a license. You must
supervise the construction yourself. You may build or improve a one - family or two- family residence. You may also build or improve a
commercial building at a cost of $25,000.00 or less (The new form states 75,000). The building must be for your own use and
occupancy. It may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is complete, the law will presume that you built for sale or lease, which is a violation of this exemption. You may not hire
an unlicensed person as a contractor. It is your responsibility to make sure the people employed by you have licenses required by state
law and by county or municipal licensing ordinances. Any person working on your building who is not licensed must work under your
supervision and must be employed by you, which means that you must deduct F.I.C.A and with- holdings tax and provide workers'
compensation for that employee, all as prescribed by law. Your construction must comply with all applicable laws, ordinances,
buildings codes and zoning regulations.
Please read and initial each paragraph.
1. I understand that state law requires construction to be done by a licensed contractor and have applied for an owner - builder
permit under an exemption from the law. The exemption specifies that I, as the owner of the property listed, may act as my own
contractor with certain restrictions even though I do not have a license.
Initial j
2. I understand that building permits are not required to be signed by a property owner unless he or she is responsible for the
construction and is not hiring a licensed contractor to assume responsibility.
Initial °
3. I understand that, as an owner builder, I am the responsible party of record on a permit. I understand that I may protect myself
from potential financial risk by hiring a licensed contractor and having the permit filed in his or he"r name instead of my own
name. I also understand that the contractor is required by law to be licensed in Florida and to list . his or li nse numbers on
permits and contracts.
Initi
4. I understand that I may build or improve a one family or two-family residence or a farm outbuilding. I may also build or improve
a commercial building if the costs do not exceed $75,000. The building or residence must be for my use or occupancy. It may
not be built or substantially improved for sale or lease. If a building or residence that I have built or substantially improved
myself is sold or leased within 1 year after the construction is complete, the law will presume that I built 95 substantially
improved it for sale or lease, which violates the exemption. i
Initial
5. I understand that, as the owner - builder, I must provide direct, onsite supervision of the construction.
Initial (J)
6. t understand that I: may not hire an unlicensed person to act as my contractor or to supervise persons working on my building or
residence. It is my responsibility to ensure that the persons whom I employ have the license required by law and by county or
municipal ordinance.
Initial c=='Q
7. I understand that it is frequent practices of unlicensed persons to have the property owner obtain an owner - builder permit that
erroneously implies that the property owner is providing his or her own labor and materials. I, as an owner- builder, may be held
liable and subjected to serious financial risk for any injuries sustained by an unlicensed person or his or employees while
working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an
owner - builder and am aware of the limits of my insurance coverage for injuries to workers on my property.
Initial
8. I understand that I may not delegate the responsibility for supervising work to be a licensed contractor who is not licenses to
perform the work being done. Any person working on my building who is not licensed must work under my direct supervision
and must be employed by me, which means that I must comply with laws requiring the withholding of federal income tax and
social security contributions under the Federal Insurance Contributions Act (FICA) and must provide workers compensation for
the employee. I understand that my failure to follow these may subject to serious financial risk.
Initial cj>
9. I agree that, as the party legally and financially responsible for this proposed Construction activity, I will abide by all applicable
laws and requirement that govem owner - builders as well as employers. I also understand that the
Construction must comply with all applicable laws, ordinances, building codes, and zoning regulations.
10. I understand that I may obtain more information regarding my obligations as an employer from the Internal Revenue Service, the
United States Small Business Administration, and the Florida Department of Revenues. I also understand that I may contact the
Florida Construction Industry Licensing Board at 850.487.1395 or http : / /www.mvfloridalicense.com /dbpr /pro /cilb/iindex.html
Initia
11. I am aware of, and consent to; an owner - builder building permit applied for in my name and understands that I am the party
legally and financially responsible for the proposed construction activity at the following address:
Initial���
12. I agree to notify Miami Shores Village immediately of any additions, deletions, or changes to any of the informa ' n at I
have provided on this disclosure.
Initia
Licensed contractors are regulated by laws designed to protect the public. If you contract with a person who does not have a
license, the Constr4uction Industry Licensing Board and Department of Business and Professional Regulation may be unable to
assist you with any financial loss that you sustain as a result of contractor may be in civil court. It is also important for you to
understand that, if an unlicensed contractor or employee of an individual or firm is injured while working on your property, you may
be held liable for damages. If you obtain an owner - builder permit and wish to hire a licensed contractor, you will be responsible for
verifying whether the contractor is properly licensed and the status of the contractors workers compensation coverage.
Before a building permit can be issued, this disclosure statement must be completed and signed by the property owner and
retumed to the local permitting agency responsible for issuing the permit. A copy of the property owners driver license, the
notarized signature of the property owner, or other type of verification acceptable to the local permitting agency is required when
the permit is issued.
Was acknowledged before me this 1 day of , 20 1
By l
who was personally known to me or who has
Produced there License or PC—A
YCA-4
OWNER
as identt;irc' tl ► l "i,,,�s�
S Ve •
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