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RF-16-3230 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax:(305)756-8972 inspection Number: INSP-273131 Permit Number: RF-11-16-3230 Scheduled Inspection Date: December 21,2016 Permit Type: Roof Inspector. Naranjo,Ismael Inspection Type: Final Roof Owner: KOLIAN,GHAZAR Work Classification: Repair Roof Job Address,117 NW 101 Street Miami Shores,FL 33150- Phone Number Parcel Number 1131010220150 Project <NONE> Contractor. JOHN BUSTA ROOFING INC Phone:(305)219-9699 Building Department Comments RENEW AND REPLACE TILE AND FELTS ABOVE I �O Passed INSPECTOR COMMENTS False Comments GARAGE DOOR Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-271941. Need to provide uplift test Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee Is paid. Deciunber 20,2016 For Inspections please call:(305)762-4949 Page 25 of 46 C I VI L Re hgE eie�ring Cor p. 2370 Southwest 123rd Avenue Mami,Florida 33175-1174 Tel:305-823-8008/305-397-6414 ENGINEER Fax:305-823-3300/305-884-8834 Website:www reilehengineermg.com December 13, 2016 John Busta Roofing 300 Northeast 91 Street Miami Shores, Florida 33138-3130 Project: ROOF TILE UPLIFT TEST REPORT Residential biome 117 Northwest 101 Street Miami Shores, Florida Information provided by client: Permit Number: RF11163230 Date Completion: December 10, 2016 Roofing Contractor: John Busta Roofing Project Number: 16-1200 (Testing Laboratory Certificate#11-0715.04) Dear Sirs; In accordance with your request and authorization, a representative of Reileh Engineering Corporation completed the Roof Tile Uplift Test at the above referenced project. This testing was performed in general accordance with Roofing Application Standard TAS No.!0() -- Standard procedure for field verification of the bonding of mortar or adhesive set the system acid.mechanically attached,rigid, discontinuous roof systems. The total of the tested roof surface area was less than 10000 square feet, and the nteaa_ height of the roof is less than 40 feet above giound surface. The type of tile used for this proievt �r;,:, rilported to be 9" Flat White Concrete Roof Tile. This tile was reportedim to have been foaed in ;;iacc. At the time of our inspection,the entire area of the roof was examined for loose tips. Not less than one(1)tile in ten(10)of all components in the field area and one(1)the in five(5) of all tiles in the perimeter and comer areas were physically examined. A minimum of one(1)test per every two(2) squares in the field, one (1) test per square in the perimeter area, ridge caps and (1)" in the comer areas were conducted. Based on our test results, we conclude that the installation of the roof tile at the a'00%,e referenced project meets the test requirement outlined in the above-mentioned protocol. Attau:iied please find a copy of our test report for,your review. Reileh Engineering Corporation appreciates the opportunity of assisting you in this project. If you hav6 any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted; Reileh Engineering Corporation Mohamad Sonny Salleh, P.E.49014 Project Manager TILE UPLIFT TEST Residential Home 117 Northwest 101 Street Miami Shores,Florida Reileh Engineering Corporation--Project Number- 16-1200—Page 2 of 3 Report of TILE UPLIFT TEST for Residential Home 117 Northwest 101 Street Miami Shores, Florida Project Number: 16-1200 Test Number Test Load Ibfj Test Status 1 35 Pass 2 35 Pass 3 35 Pass 4 35 1'ass 5 35 Pass 6 35 Pass 7 1 35 Pass Test 1-2 Corner, 3-5 Perimeter, 6-7 Field Reileh Engineering Corporation--Project Number- 16-1200—Page 3 of 3 3 5 7 6 10' I p 2 W NUMi3t;t;OF 11;51" MM11;f; - 60 5F O f lPa CAP TEST WCA110N FEW - 2 COUR - 20 5F COUR - 2 MMV L915TANa,a= 3' L MNO 5 005 11.� 1U 16-1200 0126e CAP 0 COM MA- 3'X 3' APPROX,ROOF 11;5T LOCATIONS,ACAS, ANI7 f71WN5ION5 �g cy Miami Shores Village ■. Faw T t 10050 N.E.2nd Avenue NW � � y Miami Shores,FL 33138-0000 a3 Phone: (305)795-2204 �• °' LORIfu' a r � t �� -€ '.. 'it129�t!'[ff Expiration: 05/25/2017 Project Address Parcel Number Applicant 117 NW 101 Street 1131010220150 Miami Shores, FL 33150- Block: Lot: GHAZAR KOLIAN Owner Information Address Phone Cell GHAZAR KOLIAN 117 101 MIAMI SHORES FL 33150- 117 101 MIAMI SHORES FL 33150- Contractor(s) Phone Cell Phone Valuation: $ 1,500.00 JOHN BUSTA ROOFING INC (305)219-9699 .._._._.. __...._ ....._ ... _ ........ _�... _ Total Sq Feet: 50 Type of Work:Repair Available Inspections: Additional Info:RENEW AND REPLACE TILE AND FELTS AB Inspection Type: Classification:Residential Roof Repair Scanning:3 Final Roof Review Roof Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.20 DBPR Fee Invoke# RF-11-16-62193 $2.00 DCA Fee $2.00 11/29/2016 Check#:2066 $ 116.20 $0.00 Education Surcharge $0.40 Permit Fee-Repairs $100.00 Scanning Fee $9.00 Technology Fee $1.60 Total: $116.20 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructionutherm e,I authorize the above-named contractor to do the work stated. November 29, 2016 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy November 29,2016 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 2010 BUILDING Master Permit No. 12.,•F- I(ci - Z 3C) PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC @YOOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: /®/ 67, City: Miami Shores County: Miami Dade AD: /�® Folio/Parcel#: //- 31191®• ®� __ 0JJ Q Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee SimpleTitleholder): 6 74 Z k !<®ZIA� Phone# VS• 9i`7""199.3 Address: iZ7 Aza zaz City: ��•� � ..S State �� Zip: 1346�e/iZ/ Tenant/Lessee Name: N Phone#: Email: &ZIA zaP_h a—ZZAAle va CONTRACTOR:Company Name: ®l�/(� /��f/� / -�/f!1. Phone# z1a'd f6�� Address: City: & a State: �� • Zip: � � Qualifier Name. Phone# 9 ��Z,_ State Certification or Registration M �C��-�I �r� � Certificate of Competency#: DESIGNER:Architect/Engineer: /(1� Phone#: Address: City: State: Zip: Value of Work for this Permit:$4_Iew I Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration ❑ Newepair Replace ❑ Demolition Description of Work: Jr 2q&g GA-054-GE e Specify color of color thru tile: Submittal Fee$ Permit Fee$ I CCF$ t • 2C) CO/CC$ Scanning Fee$ Radon Fee$ 2.. DBPR$ ii Z. Notary$ Technology Fee$ Training/Education Fee$ ` l� Double Fee$ Structural Reviews$ Bond$ 12o Bonding Company's Name(if applicable) Bonding Company's Address /(! City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Ad ess do 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 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. Signatures -, Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this NO day of /(/a&93 ,20 1,6 •by day of &4522 . 20 , , by 9 ZAK— 4& who is personally known to iC� ,who is personally knownD tQ a e me or who has produced AZ•40"1 .5 46C � as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: ,,f - � Sign�C.�I�J� � Sign: Print: Sa r►&f GL tH (A S Print: NNt 111111 Seal: ,•• SANDRAANNR A Seal:= RA ANNBtfSTA e :+ MY COMMISSION 9 FF 159120 �' SAV'- EXPIRES,Septem 14,2018 +, .� MY Gir..ln'•I5Si0N 9 FF 159120 Bonded Thru l tery Pulk,*r rriteM EXPIP" :emtt7er 14,2018 flL tti Bonder' :ery Pubk UndervMn APPROVED BY tans Examiner Zoning 14+ Miami shores V mail Building Department �LOR' ► 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 (LLC) 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 and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project.In these circumstances,Miami Shores Village does not require verification of workers'compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: es Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this gZit/2 day of&06gF� G� ,20 i_• By who is personally known to me or has produced - f &9&4129 as identification. Notary'.�-SWy—dA,1D SEAL: &4W14AIMI9=A = MY CMOWIIXV 0 FF 15912D EXPIRES: 14,'pis r• TWUNom pok 9 Y OFTOP STRUCTURES ROS iT F ITIV Florida Building Code 5th Edition r NOV 29 2016 j ° High-Velocity Hurricane Zone Uniform Per ° BY:_ Pe" I 1 Section A(General Informat ° Master Permit No. Process No. ° Contractor's Name ° Job Address 1 ROOF CATEGORY 1 0 ❑ Low Slope ❑ Mechanically Fastened Tile , Mortar/Adhesive Set Tiles 1 ❑ Asphaltic Shingles ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes 1 ❑ Prescriptive BUR-RAS 150 1 ROOF TYPE ° ❑ New roof Repair ❑ Maintenance ❑ Reroofing ❑ Recovering 1 ROOF SYSTEM INFORMATION 1 1 Low Slope Roof Area(SF) Steep Sloped Roof AREA(SSF)� Total(SF) �Q ° 1 Miami Shores Village ection B(Roof Plan) 1 ' us rate all I vels and sions, f drains,scuppers,overflow scuppers and overflow drains. Include dimen- 1 APP iioons of:OVEc ons anddWls,cle ly ideiu Td lensl s of elevated pressure zones and location of parapets. ° U 1 ZONING DEPT 1 1 BLDG 1 SUCiJ C TO O PLI NC 1 ST TE D OU TY UL S A D R ° 1 j 1 N 1 ° tIX I I 1 - - - - - _ 1 e 1 •• • . . 1 1 FLORIDA BUILDING CODE—BUILDING,Sth'•EDIjION(201P1 i i i i 15.37 Copyright Pgpeement , �er b��µ� ���);accessed by Elieur Palacio on Jun&2015 10:32:12 AM pursuant to license t � SECTION 1524 HIGH VELOCITY HURRICANE ZONES—REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 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 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 ant the contractor.The owner's initial in the designated space indicates that the item has been explained. 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). 4• t3r— Exposed Ceiling:Exposed,open beam ceilings s are where the underside dersrde 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. &e-- 6. 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. / /� 04 Owner/Agent's Signature ate Contractor Signature Date //-7&W /0/ ars Property Address Permit Number Revised on 7/9/2009 LD;07/01/2015; •• •Y• • • • • • •• • • •• • • • • ••• as ••• •• • • • •• • •d• •• ••• ••r ••• Y••• • •• • • • • • • • • • • • 00 Y •• • • • • •• •• ••• • • • • ••J • • • • • • • • • :00.:• • •• • •••• •••• •• • • 0 0