RF-12-1738Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 178634 Permit Number: RF -9 -12 -1738
Scheduled Inspection Date: September 28, 2012
Inspector: Bruhn, Norman
Owner: GOMEZ, JORGE
Job Address: 9969 NE 4 Avenue Road
Miami Shores, FL 33138-
Project: <NONE>
Contractor: ISAACS ROOFING & INSULATION CORP
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Repair Roof
Phone Number (305)510 -0916
Parcel Number 1132060171230
Phone: (305)234 -5234
Building Department Comments
LEAK REPAIR
Infractio Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
September 28, 2012
For Inspections please call: (305)762 -4949
Page 10 of 18
BUILDING
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
Permit No.
JE C J iE
SEP 182012
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 9910 I N E 4111 j F?-cz[ o f
City: Miami Shores County: Miami Dade Zip: 33 1 3 8
Folio/Parcel #: I 1 — 3 ao - 01 3- - (a 3
Is the Building Historically Designated: Yes NO ✓ Flood Zone: IQ 8
OWNER: Name (Fee Simple Titleholder): { ► `e v SS A ()Ji\Q2 Phone#: 30S-- s--6Z. -3- PLA
Address: 99 ■171 N C—
City: l\-4 %M■ Si,"\ ore .S State: i-
Tenant/L.essee Name: N I Ps
��-
Finail: \) GA of 1 e ZcPy DILL 0 O. C or--N
CONTRACTOR: Company Name: =5.#3.00.- S r iN ct Phone#:
Address: Z S �' , �i
City: 4M.e1T. ceV p a State: ( Zip:
Qualifier Name: ° 1A IS ,a, ,r1 Z 2 Phone#:
State Certification or Registration #: ( c.4-t324 'S (.0 - Certificate of Competency #:
Contact Phone#: Email Address:
DESIGNER: Architect/Engineer: Phone#:
zip: 33)3b
Phone#:
Value of Work for this Permit: $ / 2-00 Square/Linear Footage of Work:
Type of Work: ❑Addition ❑Alteration ®New J 2epair/Replace ®Demolition
11.4.44-
Description of Work:
Color thru tile:
Submittal Fee $ Permit Fee $ /`"`rte od 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 F.T.FCTRICAL 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 reinsp, ction fee will be charged.
Signature
Owner or Agent
The foreg • instrument was acknowledged before me this of The fo
day of ��. , 20 I L, by /116e , S S,t 64+ 97104? , day of
who is personally known to me or who has produced FL. 6 C . who
As identification and who did take an oath.
NOTARY PUBLIC:
Signature '—
/
Contractor
instrument was acknow -, ! ed befo
20 jaby 1 vl
e or who has produced
ntification and who did take an oath.
NOTARY PUBLIC:
Sign:
A 0i41)471-4- WOW ANTHONY CAPETILLO Peat.
My Commission Expires:
l Zo ab'
APPROVED BY
NOTARY PUBLIC -STATE OF NEW YORK My Co
No. 01CA6250655
Qualified in Westchester County
,f '!
-�• B<y, nk NOt3(y Public - a e o • ',r�. \Ya
e 23,2•
LT
II Commission # E,E 128810
loss Bonded Through National Notary Assn.
**00*0*000*00
Plans Examiner Zoning
Structural Review Clerk
(Revised 3 /1212012)(Revised 07110 /07)(Revi>ed O6I10/2009)(Revised 3115/09)
•
•
HIGH- VELOCITY HURRICANE ZONES
Florida Building Code Edition 2010
High Velocity Hurricane Zone Uniform Permit Application Form.
Section A (General Information)
Master Permit No Process No.
C t o?s Name S.A.Ac� (L znciA �d
qe-i (9 c 444 -IA
ROOF CATEGORY
❑ Mechanically Fastened Tile ❑ Mortar /Adhesive Set Tile
tic ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes
es
❑ Prescriptive BUR -RAS 150
ROOF TYPE �
❑ New Roof ❑ Reroofing ❑ Recovering D Repair ❑ Maintenance
ROOF SYSTEM INFORMATION
Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF)
32 <cT 3 ' .59,F -
Section B (Roof Plan)
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.
2010 FLORIDA BUILDING CODE -- RESIDENTIAL