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RF-14-1266Miami Shores Village '`� ' ``' ET -71 JUN 1,.7 014 Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 7S6 -8972 INSPECTION LINE PHONE NUMBER: (305) 762 -4949 FBC 26 LO BU LDI C7 Master Permit No. Vhez- I (P PERMIT APPLICATION Sub Permit No. ❑ BUILDING ❑ ELECTRIC 0 ROOFING ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS JOB ADDRESS: 14 NE 108 Street ❑ CHANGE OF CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County Miami Dade zip: Folio /Parcel #:11 - 2136- 011 -0070 Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Kristina Long Phone #: 305 - 588 -9313 Address: 14 NE 108 Street City: Miami Shores Tenant /Lessee Name: Email: krissam1 @netzero.net State: FL Zip: 33161 e #: CONTRACTOR: Company Name: S. R. Wharton & Company Phone #: 305- 945 -3442 Address: 1701 NE 145 Street city: Miami State: FL Zip: 33181 Qualifier Name: Steven R. Wharton Phone#: 305 - 945 -3442 State Certification or Registration #: CCC 058171 Certificate of Competency #: DESIGNER: Architect /Engineer: Phone#: Address: City: State Zip: Value of Work for this Permit: $1,350.00 Square /Linear Footage of Work: 10 to 50 SF Type of Work: ❑ Addition ❑ Alteration ❑ New 0 Repair /Replace ❑ Demolition Description of Work: Repair tile leakage, above rear garage's east sloped area with plastic cement, asphalt saturated membranes, and granulated roof membranes as needed. Install color thru tiles by adhesive foam & or mortar set. Reseal sloped to flat adjoining with plastic cements and asphalt saturated membrane, covering exposed asphalts with an aluminum asphalt coating. Specify color of color thru tile: Submittal Fee $ V ermit Fee $ Scanning Fee $ Radon Fee $ Technology Fee Structural Reviews $ (Revised02 /24/2014) Training /Education Fee $ CCF $ CO /CC $ DBPR $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zi 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, 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 I ✓�' Signature OWNER or AGENT CONTRACTOR The forgoing instrument was acknowledged before me this & day of J/i e 20 19 . by Kristina Long who is personally known to me or who has produced f1m �,as identification and who did take an oath. NOTARY PUBLIC: The foregoing instrument was acknowledged before me this day of 3 Gt yu_ , 20 / Y by Steven R Wharton , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Structural Review Clerk (Revised02 /24/2014) Sign: ` Sign: w ''i✓ Print: 1 [ i'5 Print: 1(��/ . ,�lv' I nLA 1 C Seal: ,..��;r p;;e,, DJALANTA JEAN LOUIS Notary Publ ic - State of Florida Seal: •t r�'�e•., DJALANTA JEAN LOUIS My Comm. Expires Mar 23, 2015 M"k,-z a ,� -' Notary Public - State of Florida " Commission # EE 76966 _ • : My Comm. Expires Mar 23, 2015 # # # # # # ## ##' IRPiResndeli>I7�eegMADethlnetAersn # # # # # # # # # # # # # # ## N vC # # #✓A17tii1i11�+k�k #�si�i ## # # # # # # # # # ## '' of eL ° ''r"",1•• Bonded Through National Notary Assn. APPROVED BY 9j�/f Plans Examiner Zoning Structural Review Clerk (Revised02 /24/2014) Iia R CERTIFICATE OF LIABILITY INSURANCE `--''' F6/16/2014 D /DD/YYYY) 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). PRODUCER Caton -Hosey Insurance NONTACT Paula Shephard, CISR PHONE (386) 767 -3161 FAX (386)760 -1770 C o: E-MAIL R :paula @catonhosey.com 3731 Nova Rd. INSURER(S) AFFORDING COVERAGE NAIC # EACH OCCURRENCE INSURER A :Southern Owners 10190 Port Orange FL 32129 INSURED INSURER B PERSONAL & ADV INJURY INSURER C S R Wharton & Cc INSURER D: $ 2,000,000 1701 Ne 145Th St INSURER E $ 2,000,000 INSURERF: Miami FL 33181 -1341 COVERAGES CERTIFICATE NUMBER_CL1381310053 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. ILTTRR TYPE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN POLICY NUMBER POLICY EFF MNU CD EXP UMW A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x1 OCCUR Q P Shephard, CISR /ASHO 72733491 /25/2013 /25/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE PREMISES Ea nce $ 50,000 MED EXP (Any one person) $ 5,()00 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC ircT PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS UUM-11MEDSINGUE LIMA Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident $ UMBRELLA UAB EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ HOCCUR AGGREGATE $ DIED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE a OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA ° My STATU- 0a E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 1(1, AddIlonal Remarks Schedule, if more "Nee Is mgulmed) Home Inspector H1988, Standard Roof Inspector SR189, Certified Roofing Contractor CCC058171 1!C0TICIf`ATC unl nco d AMrFl I eTInN ACORD 26 (2010/05) INS025 mmnnsi m ©1988 -2010 ACORD CORPORATION. All rights reserved. Tho er'f1Rn mama and Innn ara ranla+araA marlra of Ar'nRn SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Village of Miami Shores Building & Zoning 10050 NE 2nd Avenue AUTHORD3DREPRESENTATIVE Miami. Shores, FL 33158 Q P Shephard, CISR /ASHO ACORD 26 (2010/05) INS025 mmnnsi m ©1988 -2010 ACORD CORPORATION. All rights reserved. Tho er'f1Rn mama and Innn ara ranla+araA marlra of Ar'nRn P s STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW 0,— EFFECTIVE: 12/28/2012 EXPIRATION DATE: 12/28/2014 PERSON: STEVEN R WHARTON FEIN: 592873513 BUSINESS NAME AND ADDRESS: S R WHARTON & COMPANY 1701 NE 145 STREET MIAMI, FL 33181 SCOPE OF BUSINESS OR TRADE 1- ROOFING 2- ROOFING 000074 Local ou n ` � ei Miam, I•- Dade tou 1ty, State, of florld �a THIS $-WT A BILL —1 0 NOT PAY 3573186 BXMNESS 4AMEYLOCAVION WHARTON S R & COMPANY 1704 "NE 1 MIAMI FL 33101, r�R±cr"IP'r Ivt�� ; M AL X474 4 OWNER SEC. TYPE OF OUSINESS PAYMENT RECENEO WHARTON S R & COMPANY 196 SPECIALTY BIRLDING CONTRACTOR DY TAY.COI:LECTO lnrker(s) 1 CCCO58171 $75.00,OEI /15J2013 CREDITCARD -13 - 005600 This local Busilte�sa Tic Raoalpl o1lanfirms ofi t110 toca181I escaipt is aot a lioeaso, perms cr a carti�I111 of tha bpld v s qual"i #o 01>u lffe �� ! ", � b aay governmental or nonggvermaelnallr�atory 18vus artRCiaquiremsmswhicha'ILF Tho RECEIPT N0. above atust`1e:displayadn all Comm a ciot z_. _ . - i 1ta9 Go Ssc $�r6 For mombdormatioo, visit u mk%—:_ Amfm fiffl r Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part -time or full -time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (I.LC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore, you may be personally liable for the worker compensation injuries of a� person allowed to work under this permit Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Print Name: I tina Long � —� Signatu _ State of Florida ) County of Miami -Dade ) Sworn to and subscribed before me this day of J i_�. ?7 4 , 20 1 . BY d?, 5" 1 rd GL .L dl Y , N Notary Public - State of Florida My Comm. Expires Mar 23, 2015 Commission # EE 76966 Bonded Through National Notary Assn. Contractor Print Name: Steven R. Wharton Signature: State of Florida ) County of Miami -Dade ) Sworn to and subscribed before me this day of b% ? 4, , 20 Li_. By,� VAZI (� � of Notary Public - State of Florida My Comm. Expires Mar 23, 2015 Commission # EE 76966 Bonded Through National Notary Assn. Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form. Section A (General Information) Master Permit No. Process No. Contractor's Name S. R. Wharton & Company Job Address 14 NE 108 Street 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 ❑ New Roof ❑ Re- roofing ❑ Recovering ■ Repair ❑ Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) 15 to 20 LF Stdppinq 10 to 50 sf 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. Measured T I.eaWe Site > ,I "Im CT TO COMPLIANCE WITH ALL FWEKAL 'n C n1 INTY RUl.l -S AND nFOUL.ATIONS Total (SF) :• - 14 P1%'Ar V°.l JUN 1 7 2014 y ■ i . 18' ... . ......... .............. ... Sloped to Flat Adjoining a Miami Shores Village ARPROVED kTE 70NING DEPT BLDG DEPT Iff ° ,I "Im CT TO COMPLIANCE WITH ALL FWEKAL 'n C n1 INTY RUl.l -S AND nFOUL.ATIONS Total (SF) :• - 14 P1%'Ar V°.l JUN 1 7 2014 Owner's Notification Form HVHZ 2010 �Vel a 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 roofing contractor to provide the owner with the required roofing permit, and to explainpto 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 ite has been explained 1. Aesthetics workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion 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 T111 2. Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renai 'led 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 . townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. [V4. Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be eedfrom below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetrations of the underside of the decking may not 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 ca I a a 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. E °` . Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not ov loaded 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 overBovw SCuppe;%-iiraccordwwp with the requirements of Chapter 15 and 16 herein and the Florida Building Code, Pl y jt�g. • 9 * 0 0 • 0000 . 7. Ventilation: Most roof structures should have some ability to vent natural ai�ow th=ouib the ; • • • • interior of the structural assembly (the building itself). The existing amount of attic 4l3tiltnon snot be • 0 0 0 0 reduced. Exception: Attic spaces, designed by a Florida - licensed engineer or registe A.**hitecTfo eliminiti the attic venting, venting shall n e req ' 0000.. • • ' Ownees/A ents Signature: g t� ..' �� ' Date: • 0000.. Contractor's Signature: Permit Number: • • • Property Address: 114 NE 108 Street, Miami Shores FL 33161