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RF-12-1639�4 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 inspection Number: INSP - 182965 Permit Number: RF -9 -12 -1639 Inspection Date: December 17, 2012 Inspector: Bruhn, Norman Owner: Job Address: 1044 NE 94 Street Miami Shores, FL Project: <NONE> Contractor: MURPHY ROOFS Permit Type: Roof Inspection Type: Final Roof Work Classification: Repair Roof Phone Number Parcel Number 1132050150020 Phone: (305) 892 -1700 Building Department Comments REPAIR TO NE VALLEY Infractio Passed Comments INSPECTOR COMMENTS False Passed Inspector Comments CREATED AS REINSPECTION FOR INSP- 178016. • �i Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until For Inspections please call: (305)762 -4949 December 14, 2012 Page 1 of 1 :te: 9/12/2012 Time: 11 :48 AM To: IMCEAFAX-13057568972 N 913057568972 Prime Ins Page: 002 CERTIFICATE p9 CERTIFICATE OF INSURANCE DATE (MM/DD/YY) 09/12/2012 PRODUCER AND THE NAMED INSURED Transworld Building Trades and Contractors Liability Association, Inc. Inc., A Risk Retention Purchasing Group qualified under the Risk Retention Act of 1986; Federal Law 97-45. 7400 South Union Park Ave., Suite 201 Midvale, UT 84047 800 -851 -8364 THIS CERTIFICATE IS ISSUED AS A MATTER OF INF AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE OF INSURANCE DOES NOT AFFIRMATIVELY NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE BY THE INSURANCE POLICIES BELOW. RMATION ONLY HOLDER. THIS OR AFFORDED INSURERS AFFORDING COVERAGE INSURED Murphy Roofs, Inc 10903 N.E. 8 Court INSURER A: NOTICE: Coverage is being provided as part of a Master Group INSURER B: Policy issued to members of the Transworld Building Trades and Contractors Liability Association, Inc. INSURER C: , a Risk Retention' Purchasing Group' authorized under the Risk INSURER D: Retention Act of 1986: Federal Law 97-45. Biscayne Park , FL 33161 "LIMITS SHOWN ARE THOSE IN Prime Insurance Company EFFECT AS OF POLICY INCEPTION" COVERAGES - The policies of insurance listed below have been issued to the insured named above for the policy 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. Aggregate limits shown may have been reduced by paid claims. TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY COMMERCIAL PRC2605- 12060011 06/09/2012 06/09/2013 EACH OCCURRENCE s $300,000.00 U GENERAL LIABILITY Claims Made Exclude Products FIRE DAMAGE (Any one fire) s N/A MED EXP (Any one person $ N/A PERSONAL ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP /OP AG $ N/A 5 $300,000.00 1S j � GEN'L 10 Exclude Completed Operations AGGREGATE LIMIT APPLIES PER: POLICY ECT II LOC Per Person s $300,000.00 AUTO a LIABILITY ANY AUTO ANNUAL AGGREGATE a ALL OWNED AUTOS III SCHEDULED AUTOS n HIRED AUTOS Li NON -OWNED AUTOS DRIVE AWAY BODILY INJURY (Per Parson) BODILY INJURY (Per Accident) 5 PROPERTY DAMAGE (Per Accident) GARAGE LIABILITY/MANUSCRIPT FORM SCHEDULE AUTO PER PERSON • a • Li la • G.K.L.L. O.T.R.P.D. D.O.C. CARGO ON HOOK EMPLOYEE DISHONESTY WRONGFUL REPOSSESSION PERACCIDENT AGGREGATE S PROPERTY DAMAGE s EXCESS LIABILITY OCCUR ® CLAIMS MADE RETENTION $ , EACH OCCURRENCE S AGGREGATE LIMITATION OF COVERAGE FOR ADDITIONAL INSURED DESCRIPTION OF OPERATION /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Coverage is limited to only insured activities or operations on the Participant Member Declaration Certificate or as may be separately endorsed. Roofing - residential "W 1 CERTIFICATE HOLDER Ili I ADDITIONAL INSURE LJ !LOSS PAYEE Miami Shores Village 10050 Northeast 2nd Avenue Miami Shores, FL 33138 Fax Number: 3057568972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WLL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIV ,, IL Miami Shores Village Building Department 90050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ' ^DING INSPECTION'S PHONE NUMBER: (305) 762.4949 iii IL PERMIT APPLICATION FBC 20 10 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): e04 rue % h YYluy °C-C„, Phone #: 304(' la- 0 �.p - 31aY Address: /0 %II Ue.. q q City: /ll&vwb% 66 re State: C.- Zip: 331 3 Tenant/Lessee Name: Phone #: Email: Master Permit No. JOB ADDRESS: i o tp jtJ t 9 i? City: Miami Shores County: Miami Dade Folio/Parcel #: 11 3a0c. ots" oc),0 Is the Building Historically Designated: Yes NO Zip: 33l 3 Flood Zone: CONTRACTOR: Company Name: V ` 1 '®''C Phone #: 1 16 Address: City: r S ra- '� �`�- State: Zip: 3 D/ G 1 l Qualifier Name: —�`'KP '� i� --$ �m Phone #: C i- a 1 5 9 19 y State Certification or Registration #: Certificate of Competency #: TT Ste'- 1 Contact Phone #: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ cgh c7 Square/Linear Footage of Work: O Type of Work: Addition OAlteration ONew Repair/Replace ODemolition Description of Work: i " = JvO N.l �i 0-703 kit 9 Email Address: Submittal Fee $ Permit Fee $ /27 CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ n8 -(0.0 Bonding Company's Name (if applicable) Bonding Company's Address City State Zip ortgage Lender's Name (if applicable) ortgage 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 ommenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating onstruction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, LLS, POOLS, FURNACES, BOB FRS, HEATERS, TANKS and AIR CONDITIONERS, ETC )WNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all pplicable laws regulating construction and zoning. `WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF OMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR MPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN ANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE CORDING YOUR NOTICE OF COMMENCEMENT." otice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must romise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person hose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site or the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such 'd notice, the nspection will not be approved and a reinspection fee will be charged. Owner or Agent he foregoing instrument was acknowledged before me this ay of /MY , 20 L4-, by (°oouti e_ /Y1fl-t2tZD Cl-o ho is personally known to me or who has produced As identification and who did take an oath. OTARY PUBLIC: Ign: nt: y Commission Expires: 4.0tY • p4A‹i S AI\ ▪ �� * *** *********** ***** *** ** PROVED BY Signature Con The foregoing instrument was ac day of U , 20 n-; who is ged before me this 14 l2, who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: \\ \ \N114111t 11 J ''', • • State Off as Acosta My Commission Expires. 'et. �44.4 ;`;4 %• o �� '•�~ • ti{ 9 aksksk* akakskskakskakNa: kskskskskakHsskNa*nk *akakHasks **(ol mlti'l l►� 4*** Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Master Permit No. Contractor's Name Job Address /0 V 4 f\ Florida Building Code Edition 2010 High-Velocity Hurricane Zone Uniform Permit Application Form. Section A (General Information) Process No. O Low Slope O Asphaltic Shingles 0 New Roof 0 Reroofing Low Slope Roof Area (SF) Sketch Roof Plan: Illustrate all levels and Include dimensions of sections and levels, parapets. EIVED SEP 0 4 201Z ROOF CATEGORY O Mechanically Fastened Tile O M'etal Panel/Shingles O Prescriptive BUR-RAS 150 ROOF TYPE 0 Recovering DEPT ROOF SYSTEM INFORMATION Steep Sloped Roof Area (SF) Section B R P ikPnioWdr-Ok featly It1 0 Mortar/Adhesive Set Tile o Wood Shingles/Shakes r - ; -2 • 'arni lores VI age APPROVED B Y ZONING DEPT ' "'CT I() nr N,In! r!-■ DATE ''cF•(/) AI I* pa PaLL 0 Maintenance Total (SF) ill d overflow drains. es and location of • 2010 FLORIDA BUILDING CODE — BUILDING ROOF ASSEMBLIES AND ROOFTOP STRUCTURES SECTION 1525 HIGH - VELOCITY HURRICANE ZONES UNIFORM PERMIT APPLICATION Florida Building Code Edition 2010 High - Velocity Hurricane Zone Uniform Permit Application Form. INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED 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 Prescriptive BUR -RAS 150 A,B,C 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 1,2,3,4,5,6,7 ; Wood Shingles and 9 es - ' D 1,2,4,5,6,7 Other As Applicable 1,2,3,4,5,6,7 ATTACHMENTS REQUIRED: 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 of Product Approval 5. Municipal Permit Application 6. Owners Notification for Roofing Considerations (Reroofing Only) 7. Any Required Roof Testing/Calculation Documentation 15.33 010 FLORIDA BUILDING CODE — BUILDING CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self - performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: R,0 NAUD 'd` CO N N (MCC CD PERMIT # 12-. la 3 Cl ADDRESS: b V Lj 9 N r'�-_- CH s FOLIO NUMBER: II -3Z06-01 5 ^ cY 2°FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): COST OF PROPOSED IMPROVEMENTS: O 0 0 ` 0 (ATTACH COPY OF CONTRACT) TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): OWNERS SIGNAT PLANREVIEWER: (attach appraisal): `4' °� a t 5 t 2_ DATE: PLAN REVIEWER SIGNATURE: DATE:rd At%4C" kr-/JC:Es-fie OPT (--(_(-2_ 0,„24,3 Created on June 2009 SUBSTANTIAL IMPROVEMENT / DAMAGE LIST (NOTE: THIS LIST IS INTENDED FOR GUIDANCE ONLY, AND IS NOT ALL INCLUSIVE) ITEMS TO BE INCLUDED ALL STRUCTUAL ELEMENTS, INCLUDING Foundations including; Spread footing, Continuous footing, isolated footing, piles and pile caps Slabs including; Monolithic, floating, elevated Walls including; Exterior walls, Bearing walls, Shear walls Beams, Tie Beams, Columns and Posts Wood decking, Floor and Roof Sheathing Trusses, Joist Windows /Doors ALL BUILDING ELEMENTS, INCLUDING Interior Partitions, Walls, Columns Drywall, Ceilings, Built in Furniture, Cabinets, Vanities All Fixtures Flooring, Tile, Carpet, Stone, Linoleum, ect. All Finishes including Drywall, Paint, Stucco Plaster, Paneling, Tile, Marble, and Moldings Roofing Material ALL HARDWARE ALL UTILITY and SERVICE EQUIPMENT HVAC Electrical System and Equipment Plumbing System and Equipment Security System and Equipment Central Vacuum System Plumbing Fixtures Lighting Fixtures and Ceiling Fans Water Systems including Softeners /Filtration Created on June 2009 ALSO: All Labor and other Costs associated with Demolition, Removing, Replacing, Installing Building or Altering Building Components Construction Management / Supervision Overhead and Profit Equivalent cost for: Donated Materials Volunteer Labor (including owners and friends) Any Improvements Beyond Pre - damaged Condition, including; Utility Upgrades Code Upgrades ITEMS TO BE EXCLUDED Plans and Specifications Survey Costs Elevation Certificate Costs Permit fees Debris Removal Items not considered to be REAL Property Rugs, Furniture, Refrigerator, Appliances not Built -in Outside Improvements, Including; Landscaping Sidewalks Patios Fences Yard lights Sheds Gazebos Irrigation Pool