RF-13-465Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 186990 Permit Number: RF- 3- 13-465
Scheduled Inspection Date: March 21, 2013
Inspector: Bruhn, Norman
Owner: PODOLSKY, ABRAHM
Job Address: 136 NW 96 Street
Miami Shores, FL 33150-
Project: <NONE>
Contractor: DALEY ROOFING INC
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Repair Roof
Phone Number (305)758 -6150
Parcel Number 1131010240280
Phone: (305)754 -9892
Building Department Comments
ROOF REPAIR
Infractlo Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Passe ��4/
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 21, 2013
For Inspections please call: (305)762 -4949
Page 21 of 40
3�i y 13 - /94-7
DING
PERMIT APPLICATION
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
FBC 20
Permit No. aOS
Master Permit No.
Permit Type: BUILDING ROOFING
JOB ADDRESS: /34o A/it) 9b
City: Miami Shores County: Miami Dade Zip: 33/50
Folio/Parcel #:
Is the Building Historically Designated: Yes NO Flood Zone:
OWNER: Name (Fee Simple Titleholder): %4"/V77JJ/4o C'®f(/��'z Phone #:
Address: / c3& /ZJM '?10
City: /f l/J 7111 s-/Dice State: Zip: r
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR: Company Name: .1)/9-6671 /1-€9 1A i' /NCB Phone #:
Address: '?f iltr, iCto
City: A.1/6717/ cs State: Zip: ,3 3%
Qualifier Name: L)471,% hike/ Phone#:
State Certification or Registration #: O(ii067/",i 0 Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit $ a Square/Linear Footage of Work: 2
Type of Work: Addition OAlteration New epair/Replace ODemolition
Description of Work: (I)) Q2AliliaP. : 20 it tin 77 U i, .2 &hos 0 ,con-(i141 20
1J ±_
- �. Mum_ L
Kul) .
Color thru tile:
************* * *** x ****** ** ***+x*****a *** Fees******** ***: a********** ***:x****************** CI)
Submittal Fee $ Permit Fee $ /V M Q CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
pal
TOTAL FEE NOW DUE $ ((M•c._)
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 attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first ' ection w .ch occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection wi be app; ed and a r pection fee will be charged.
Signature / \,
Owner or Agent �1
The foregoing instrument was ac, owledge efore me this
day of
who personally known
As
NOTARY ' UBLIC:
Si
me or who has produced
, -I_ I . • I ,II • 1. 1 1
Q,ti • t ANT�NETTE SABARESE
k: •> ,ri MY COMMISSION 8 0093
EXPIRES: October 5, 2014
ed Tlru Notary Pubac Underwr&s
Print:
My Commission Expires:
&J6 t .
Signature
YIA_ 0.,S4,
Contractor
The foregoing instrument was ackno
day of 1l '.ZC. 20 13 , by
ed before op
it, 1.,
wh is personally known to me .r who has pr duced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commissi
Exio' C u..`Qp,< Bonded Through National Notary Assn.
-k:
**** *x:+ x* *x: ****** *+ xu: ******* ****x: ****** *** **+ x********** ****x: x: *************** ** *** *** ** **:+x**** * ******** *******
APPROVED BY
Plans Examiner
Zoning
Structural Review Clerk
(Revised 3 /12/2O12)(Revised 07 /10 /07)(Revised 06 /10 /2O09)(Revised 3/15/09)
1070 uniform rf app RED.pdf - roofing permit.pdf
http:// www. miamidade .gov /development/library /permits /roofing - perm...
Florida Building Code 2010 Edit
n
R7F13--4(e5
High Velocity Hurricane Zone Uniform Permit Ap,
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TE
2 of 5
glasfeePsorsft No
Contractor's NNstne j' r-OOh N l
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ROOF CATEGORY
0 Law Stops 0 M harries t Fastened Tile
0 Asphaltic 0 hart PanalWShhngtos
Shingles
0 'Prescriptive BUR -RAS
ROOF TYPE
Now Roof 0 Re-Roofing 0 :fig
�UUJL.I.I ICJ UUIVINUANt>b vCIITALL FEDER
e.• • . t► a s►D -
EGULATIO
tow: Moos Roof
11/.'itortariAdhesive fiat " Tile
0 Wood ShingleslShatces
Are there
15t} Gas Vent Stacks?
Yes J No J
Type: Natural J LPGX J
)(Repair 0 Maintenance
ROOF SYSiTEMMFORMATION
Stec Sloped! Roof Area Total
Seel on'B (Roof Plan}
all wets and *actions, :roof ins, scuppers, overflew:
s. Incsl cde dimana lone of sus and faits, clearly
an tocaVOn.ot per.
3/7/2013 12:29 PM
SECTION 1524
HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING
CONSIDERATIONS
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rid= dreatatisttions. : .44 ( r n3 -1; . Ity, htoviitng iiters eliminate ..:gaff ,. - ,:; : , ;, a.,mitdittte
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.
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and ff emlarize :albs p wauiactiw,. >.r =ay outzbe c r =r.;:,ta ttlitittecoait y
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Property Address
Permit Number
Rer1,2012005,Computer Services, Bufdbrg Department