RF-13-437 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)7564972
Inspection Number: INS P-199102 Permit Number: RF-3-13-437
Scheduled Inspection Date: September 27,2013 Permit Type: Roof
Inspector: Rodriguez,Jorge
Inspection Type: Final Roof
Owner: ALICIA WELCH,JUSTIN BRENNER Work Classification: Repair Roof
Job Address:334 NE 100 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060135450
Project: <NONE>
Contractor: EARL W JOHNSTON ROOFING, INC. Phone: 954-989-7794
Building Department Comments
ROOF REPAIR Infractio Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-186793. PLANS AND PERMITS
MISSING
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
September 26,2013 For Inspections please call: (305)762-4949 Page 6 of 22
Miami Shores Village
Building Department MAR M52W3
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 (
Tel: (305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
FBC 20
C
BUILDING Permit No. 1-3 93-�i—
PERMIT APPLICATION Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: 33 y All Joe 5r
City: Miami Shores County: Miami Dade
Folio/Parcel#:
Is the Building Historically Designated:Yes NO Flood Zone:
OWNER:Name(Fee Simple Titleholder):VDSTA� Isir�Z Phone#: 202 qA
Address:_ 33!j A)E /OD 57-
City: of;AAli State: 2Q Zip:
Tenant,Ussee Name: Phone#:
Email:
CONTRACTOR:Company Name: 44RC Ll 9j W gfwfix4 1.1i E Phone#: 9r, 9V 77 9X
Address: 5*7v4/ &&J44 5r
City: H®nyw"4 State: zip: .?,Z®Z�5
Qualifier Name:AVC wJ V#451 41 Phone#:
State Certification or Registration#:CCC°aX7 O 7 Certificate of Competency#:
Contact Phone#: Email Address:
DESIGNER:Architect/Engineer: Phone#:
Value of Work for this Permit:$ Square/Linear Footage of Work: 6-Z) S're
Type of Work: ❑Addition DAlteration ONew ) Repair/Replace ODemolition
Descriptionof Work: &Ai/f AR09 A17p Od fRjaAJZ!/ 9fma ft rLiZ ea?Zd& /2,--le
Col®r thru tile:
xx�xxx�x�xx���x�xxxx�xxxx��mxx�x�xx�xx�Fee04
Submittal Fee b Permit Fee$ CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Bond$
Notary$ Training/Education Fee$ Technology Fee$
Double Fee$ Structural Review$
TOTAL FEE NOW DUE$ 4
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 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$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to a_ltachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection w ' occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspectio wil o e proved and a reinspection fee will be charged.
Signature Signature
Owner or Agent Contractor
The foregoing instrument was acknowledged before me this 01M The foregoing i strument was acknowledged before me thi
day of_F60 ,24_�—,by T IVY � pV�� day of ,20 L-3,by J h 11
who is personally known to me or who has produced 1 J who is personally known to me or who has produced
As identification and who did take an oath. as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: Print:
9 0
1V�y Commission pines: Meg A Romeo My Commission M® A Romeo
�o My Gommi.sio.EE 202823 '� My Gomm18$W EE 202823
Of oe Expires 08/22/2018 os w Expire.08/32/2016
APPROVED BY °y 7 Plans Examiner Zoning
Structural Review Clerk
(Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09)
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES r t— a m isShores v i!I c e
1i11PPR-(_A'--E) By � L.AITC
Ml fJ1 Florida Building Code Edition NG DEPT
�..J�
High-Velocity Hurricane Zone Uniform Permit Apj I �F[� 'I J
ftcti n Ge ne a o
E
Master Permit No.
wrrH Ail FEuERAL
��J�PECULATIO�IS
Contractor's 4iame F - —��
® -
Job Address �.�V Ai MOO .3r
■
: ROOF CATEGORY
W
W
❑ Low Slope ❑ Mechanically Fastened Tile Mortar/Adhesive Set Tile
a
e
E3 Asphaltic Shingles 13 Metal Panel/Shingies [3 Woad Shingles/Shakes
W
W
❑ Prescriptive BUR-RAS 150
tl
ROOF TYPE
0 New Roof ❑ Reroofing ❑ Recovering Repair ❑ Maintenance
a
ROOF SYSTEM
INFORMATION
Law Slope Roof ®L teep Sloped Roof Area(SF) Total(SF)
■ '�e � i3 Roof Plan)
Sketch Roof Plan:Illustrate a u,a a d tions r of drains,scuppers,overflow scuppers and overflow drains.
o include dimensions of sect) d Is rl ntify dimensions of elevated pressure zones and location of
parapets.
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15,34 2010 FLORIDA,BUILDING CODE—BUILDING i
i
SECTION 1524
HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING
CONSIDERATIONS
1524.1 As it pertains to this section, it is the responsibility of the roofing 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 adjacent box indicates that the
Aare s been explained.
1. Aesthetics-Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane
for the purpose of providing that the roofing system meets the wind resistance and water intrusion
ance standards. Aesthetics (appearance) issues are not a consideration with respect to
workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a
z 'ng code, should be addressed as part of the agreement between the owner and the contractor.
2. Renalling flood Decks: When replacing roofing, the existing wood roof deck may have to be
ed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the
orida Building Code. (The roof deck is usually concealed prior to removing the existing roof system).
- . S. Common Roofs: Common roofs are those- which have no visible delineation between
n ighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing
Vn
r and/or owner should notify the occupants of adjacent units of roofing work to be performed.
4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking
ewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing
etrations of the underside of the decking may not be acceptable. The Florida Building Code
pro ' es the option of maintaining this appearance.
cP5. Ponding Mater: The current roof system and/or deck of the building may not drain well and mtly
water to pond (accumulate) in low-lying areas of the roof. Ponding can be an indication of structural
di s 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
o 1 inal roofing system is removed. Ponding conditions should be corrected.
5. Overflow scuppers (wall outlets). it is required that rainwater flows off so that the roof is not
o e oaded 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 ma y necessary to install overflow scu
a ordance with the Florida Building Code, Plumbing. �` peers in
7. Vent Lion: Most roof structures should have some ability to vent natural airflow through the
in nor of the tructural assembly (the building itself). The existing amount of attic ventilation shall not be
re uce . It ay be beneficial to consider additional venting which can result in extending the service life of
t ro
is/Agents Signature Date Contracto Signat re
Property Address Process Number
Miami-Dade My Home Page 1 of 2
My Home '
'
MIAMI°DADE
Show Me:
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Comparison tip 148fHST
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Portability S.O.H.Calculator is
Water
Summary Details:
Folio No.: 11-3206-013-5450 x±
Property: 334 NE 100 ST W
Mailing JUSTIN S BRENNER f
Address: ALICIA H WELCH
1345 BIARRITZ DRIVE 5
MIAMI FL
/1 #,
33141- r• � t� � ; L ft�° t
Property Information: e
Primary Zone: 1000 SGL FAMILY- to `
2101-2300 SO {
r
CLUC: 0001 RESIDENTIAL-
SINGLE FAMILY
Beds/Baths: 2/2 T
Floors: 1
Livinq Units: 1
d'Sq Footage: 1,488 Aerial Photography-2012 0 112 ft
Lot Size: 8,625 SO FT
Year Built: 1939
MIAMI SHORES SEC 1
MD PB 10-70 LOT 8& My Home I Properly Information I Propeqy Taxes
Legal 1/2 LOT 7 BLK 40 LOT I MM Neil I Property Appraiser
Description: SIZE 75.000 X 115 OR
19157-2636 05 2000 1 Home I Using Our Site I Phone Directory I Privacy I Disclaimer
OR 28211-3345 0712 01
Assessment Information:
Year: 2012 2011
Land Value: $123,627 $107,502 If you experience technical difficulties with the Property Information application,
Building Value: $115,158 $115,158 orwish to send us your comments,questions or suggestions
Market Value: $238,785 $222,66 please email us at Webmaster.
Assessed Value: $154,657 $150,15
Exemption Information: Web Site
ear: 1 2012 1 2011 ®2002 Miami-Dade County.
Homestead: 1 $25,000 $25,000 All rights reserved.
2nd Homestead: I YES i YES
< Taxable Value Information:
Year: 2012 2011
Applied Applied
Taxing Authority: Exemption/ Exemption/
Taxable Taxable
Value: Value:
Regional: $50,000/ $50,000/
$104,657 $100,153
County: $50,000/ $50,000/
$104,657 $100,153
City: $50,000/ $50,000/
$104,657 $100,153
School Board: $25,000/ $25,000/
$129,657 $125,153
Sale Information:
Sale Date: 7/2012
http://gisims2.miamidade.gov/myhome/propmap.asp 3/1/2013
Data
CERTIFICATE OF LIABILITY INSURANCE 3/6/2013
Producer: Lion Insurance Company This Certificate is Issued as a matter of Information only and confers no rights
2739 U.S. Highway 19 N. upon the Certificate Holder. This Ceruficate does not amend,extend or alter
Holiday, FL 34691 the coverage afforded by the policies below.
(727)938-5562 1 Insurers Affording Coverage NAIC#
Insurer A: Lion Insurance Company 11075
Insured: South East Personnel Leasing, Inc. & Subsidiaries
2739 U.S. Highway 19 N. Insurers'
Insurer C:
Holiday, FL 34691
Insurer D:
Insurer E:
Coverages
The policies of Insurance HsW below have been Issued named above for the policy period ce ng any req reme tens or condition of any contract or other document respell
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
rmits show may have been reduced by
paid claims.
MR ADDL Policy Effective Policy Expiration Date
LTR tiSRD Type of Insurance Policy Number Date Limits
(MM/DD/YY) (MM/DD/YY)
GENERAL LIABILITY EachOcamerce
Commercial General Liability Damage to rented premises(EA
Claims Made Occur pence) S
Mad Exp
Personal Adv Injury
eneral aggregate limit applies per.
t3ererei Aggregate
Policy ❑Project ❑ LOC
Products-Comp/Op Agg
UTOMOBILE LIABILITY Combined Single unit
(EA Accident) G
Arty Auto Bodily Injury
All Owned Autos
(Per Person)
scheduled Autos
Hired Autos BodilyInuY
Non-Owned Autos (Par Accident)
Property Damage
(Per Accident)
EXCESSIUMBRELLA LIABR.ITY Each Occurrence
Occur ❑Clairrrs Made Aggregate
Deductible
A Workers Compensation and WC 71949 01/01/2013 01/01/2014 x wC Statu- OTH-
Employers'Liability I tDry Limits I ER
Any proprietor/pattrter/executive officer/member E.L.Each Accident $1,000,000
excluded? .No E.L.Disease-Ea Employee $1,000,000
If Yes,describe under special provisions below.
E.L.Disease-Policy Limits $1.000.000
Other Lion Insurance Company Is A.M.Beet Company rated A-(Excellent). AMB#12616
Descriptions of Operations/Locations/Vehlcles/Excluslons added by Endorsement/Special Provisions: Client ID: 36-66-176
Coverage only applies to active employee(s)of South East Employee Leasing Services,Inc.that are leased bo the following"Client Company":
Earl W.Johnston Roofing,Inc.
Coverage only applies to Injuries Incurred by South East Personnel Leasing,Inc.&Subsidiaries active employees) ,while working in Florida.
Coverage does not apply to statutory employee(s)or independent contractor(s)of the Client Company or any other entity.
A list of the active employee(s)leased to the Client Company can be obtained by faxing a request to(727)937-2138 or by calling(727)938-5562.
Project Name:
ISSUE 03-06-13(SD)
Begin Data,1/10/2012
CERTIFICATE HOLDER CANCELLATION
VILLAGE OF MIAMI SHORES should aryoft a above described poUGes be cancelled before to expiration date thereof,the Issuing insurer will
endeavorto mall 30 days written notice to the certificate holier named to the left,butfailure to do so shell Impose no
BUILDING&ZONING DEPT. obligation or liability of ary kind upon the insurer,its agents or representatives.
10050 NE 2 AVE
MIAMI SHORES, FL 33138
Ar
ell
--098"N EARJ001 OP ID:TO
%`.°R° CERTIFICATE OF LIABILITY INSURANCE DATE(M "w"m
06/26/12
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 policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
:ODUCER 321-725-7000 NAME:
N.Edens Sc Company 321-725-7856 PHONE
►mmercial Ins of Brevard,Inc o Ext: Arc No):
S Fifth Avenue,Suite 108 ADDRESS:.
italantic,FL 32903
Grose C.O'Brien INSUR AFFORDING COVERAGE NAIC B
INSURER A:Canal Indemn"y Company
sUREO Earl W.Johnston Roofing Inc. INSURER B:Ma fre Insurance Company .34932
5721 Dewey Street INSURER C: i
Hollywood,FL 33023-1917
INSURER D
INSURER E:
INSURER F:
OVERAGES CERTIFICATE NUMBER: 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.
IR
IL TYPE OF INSURANCE POLICY NUMBER POLICY I LIMITS
GENERAL LIABILITY I EACH OCCURRENCE S 1,000,000
X COMMERCIAL GENERAL LIABILITY GL103266 07/01/12 07101/13 I PREMISES Ee occurrencel $ 50,00
CLAIMS-MADE `X OCCUR MED EXP(Any ate person) $ 5,00
PERSONAL B ADV INJURY $ 1,000,00
GENERAL AGGREGATE $ 2,000,00
GEML AGGREGATE L
GATE LIMIT APPLIES PER:
OC PRODUCTS-COMPIOP AGG $ 2000,00
X , POLICY
I 'PRO- I $
AUTOMOBILE LIABILITY i I COMBINED SINGLE LIMIT- 500,000
L,50100006080 1 X ANY AUTO 07/01/12 07101N 3 BODILY INJURY(Per person) IS
I AAL OWNED SCHEDULED I BODILY INJURY(Per acddent),$
K
NON-OWNED + PROPER DAMAGE $
X 'HIRED AUTOS X AUTOS �ident
i
$
UMBRELLA UAB HOCCUR i EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
i DED I RETENTION$ 1 $
1 WORKERS COMPENSATION � i TWC srATU- i I OTH-i
AND EMPLOYERS'LIABILITY
ER
ANY PROPRIETOWPARTNERIEXECUTIVE YIN i i E.L.EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED? F-�i N I A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
N ye,descr unde
DESsCRIPTION ibe OF Or PERATI NS below I I i E.L.DISEASE-POLICY LIMIT $
i
SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Sc(tedule,It more space Is required)
°_RTIFICATE HOLDER CANCELLATION
MIAMISH
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Building 8r Zoning Department
Attn:Margarita AUTHORIZED REPRESENTATIVE
10050 N.E.2nd Avenue Theresa C.O'Brien q Miami Shores,FL 33138
®1988-2010 ACORD CORPORATION. All rights reserves:.
:;ORD 25(2010105) The ACORD name and logo are registered marks of ACORD