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RF-13-399 Miami Shores Village 7FEB c: �� Building Department 2 7 2013 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 2010 BUILDING Permit No. PERMIT APPLICATION Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS: I o T5 NF, 9(o 6 2-. City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO ✓ Flood Zone: OWNER:Name(Fee Simple Titleholder): I f� P-60 -"f LO-0 G° 4W rJ Phone#: I`-'-\'10�'-a- Address: S to E_ ` G S-Ir City: H ( Itm 1 S ffD Rte State: r`" Zip: '33 13 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: f� RO0 FI t3& 41A'-(ST--_4jCPhone#: Address: (-I�1.1 .s, S!& � C.,City: P`v j W 0 0 io State: zip: 33 a 2 3 Qualifier Name: �C,#��'1`� iA"S S p Phone#: State Certification or Registration#: CC-C- 132 o Certificate of Competency#: Contact Phone#: L 1 61& 6 -1 (% Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit:$ e2 416 60.00 Square/Linear Footage of Work: Type of Work: ❑Addition likAlteration ❑New ❑Repair/Replace ❑Demolition Description of Work: Color thru the: � ***************************************Fees******************************************** 64 Submittal Fee Permit Fee$ ,J CCF$ CO/CC$ 3Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ Bon(Ang Company's Name(if applicable) #" I t- Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) IA 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 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. 42V Si�ture Signature ner o gent W C/ ntractor The foregoing instrument was acknowledged before me this �O The foregoing instrument was acknowledged before me this �O day of 20 3 by M A RC-0 RY t_Cr\)&4L4-3 day of F-e b. 20 13,by 1&F-FRQf 6f}-Ss who is personally known to me or who has produced who is persona own 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:— Itq (9-U- 5we -v Print: ,..nn vns ANN CASANOVA Print: .PRY Pu MY COMMI SS 10#N E 6581 My Commission Expires. ' * tember 19,2014 My Commission Expi MY COMMISSION#EE 016581 * EXPIRES:Sep Sem ir EXPIRES:September 19,2014 m or gird Thru Budget Notary 'qi OF F._oO Berdsd Thru Budget Notary Servicer. lRTEOF Flop` APPROVED BY —1_ Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) SNORES y lose p...� Miami Shores Village � - Building Department ORIDp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EA0iZffi1EA PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION �$30.00PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE(CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE(CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE(EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES,FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: C- BUSINESS ADDRESS: q ( � S S g CITY -`l iia&D-o STATE ZIP CODE BUSINESS PHONE: ) 9 � (o -L 17< FAX NUMBER( CELL PHONE O) q OR-a--)-oy QUALIFIER'S NAME: ncic-9,51-f BASS QUALIFIER'S LIC NUMBER: eC�C- 13� )FRP E-MAIL ADDRESS(IF APPLICABLE): Created on 3M9109 BY MLDV 1 RV 3126109 MLDV BROWARD COUNTY M*0"A., BUSINESS TAX RECEIPT i 115 S. Andrews Ave., Rm. A-100;,Ft. LaLsiderdale, FL 33301-1895—954-831-4000 VALID OCTOBER 1,2012 THROUGH SEPTEMBER 30,2013 DBA: Receipt#:ROOF NG/SHEET METAL CONT TOR Business Name: -1213 A ROOFING SPECIALIST INC Business Type-� Yp (ROOFING CONTRACTOR) Owner Name:JEFFREY BASS Business Opened:04/17/2002 Business Location: 911 S 58 AVE BAY N State/County/Cert/Reg:0001327880 HOLLYWOOD Exemption Code: Business Phone: Rooms Seats Employees Machines Professionals 2 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 I THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: A ROOFING SPECIALIST INC Receipt #02A-11-00007004 911 S 58 AVE BAY N Paid 09/25/2012 27.00 HOLLYWOOD, FL 33023 2012 - 2013 I NC# 6 2 2 8 2 6 8 STATE,OF FLORIDA- i r. I DEPARTMENT ..OF"BUSINESS° AND PROFESSIONAL REGULATION CONSTRUCTIONINDUSTRY LICENSING BOARD SEQ#L12072600999 1 LICENSE NBRi< dijp 07 26 2012 127003358 CCC132'78� - � i The ROOFING CONTRACTOR Named be how" IS CERTIFIED Under the -provisions of Chaptr' Expiration date: AUG 31, 2014' ` {� r 'BASS, JEFFREY"H A'. A ROOFING SPECIALIST INC 911 SOUTH 58TH AVE UNIT A HOLLYWOOD FL 33023 KEN LAWSON I RICK "SCOTT., A SECRETARY I GOVERNOR i DISPLAY AS REQUIRED BY LAW ��..p _.._.. Aco® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `� 2/26/2013 PRODUCER (407)838-3445 FAX: (407)838-3460 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION LRA Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 498 S Lake Destiny Rd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Orlando FL 32810 INSURERS AFFORDING COVERAGE ' NAIC# INSURED ,INSURER A.Starr Insurance & Liability 38318 A Roofing Specialist Inc INSURER B:Evanston Insurance Company 35378 911 S 58th Ave INSURER C. INSURER D: Hollywood FL 33023 INSURER E: COVERAGES 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 05UCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'Lj POLICY NUMBER j POLICY EFFECTIVE :POLICY EXPIRATIONLIMITS LTR INSR TYPE OF INSURANCE ,DATE MM/DD/YYYY DATE MMIDD/YYYY GENERALUABILITY j EACH OCCURRENCE $ 1,000,000 �' i DAMAGE TO RENTEO-- COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 50,000 A CLAIMS MADE X ,'OCCUR sipGGL0007902 1/20/2013 1/20/2014 ;MED EXP(Any one person) $ 5,000 I i j PERSONAL 8 ADV INJURY j$ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:. PRODUCTS-COMP/OP AGG $ 2,000 000 ILi POLICY Y1 PROT I I LOC j�AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ! !ANY AUTO I I(Ea accident) $ j—�ALL OWNED AUTOS j j !� I BODILY INJURY $ j I � SCHEDULED AUTOS (Per person), I 'HIRED AUTOS ! ' i BODILY INJURY $ (Per accident) 1 NON-OWNED AUTOS 1 PROPERTY DAMAGE j$ (Per accident) I GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTOOTHER THAN EA ACC $ AUTO ONLY. AGG $ j EXCESS I UMBRELLA LIABILITY .EACH OCCURRENCE $ 1,000,000 X OCCUR CLAIMS MADE AGGREGATE S 1,000,000 j $ B _ DEDUCTIBLE XOVA507213 1/20/2013 1/20/2014 $ RETENTION $ I 1$ WORKERS COMPENSATIONWCSTATU- '0TH-I AND EMPLOYERS'LIABILITY j TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE r YIN '. E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E L.DISEASE-EA EMPLOYEE $ I If yes,describe under ' SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT;$ OTHER I ' DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Miami. Shores Village Building IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Department 10050 NE 2nd Avenue REPRESENTATIVES. Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE J Lumbra, Jr./RERRIE ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(2D0901).Of The ACORD name and logo are registered marks of ACORD Data CERTIFICATE OF LIABILITY INSURANCE 2/26/2013 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 Certificate does not amend,extend or alter Holiday, FL 34691 the coverage afforded by the policies below. (727) 938-5562 Insurers Affording Coverage NAIC# Insured: South East Personnel Leasing, Inc. & Subsidiaries; Insurer A: Lion Insurance Company 11075 2739 U.S. Highway 19 N. Insurer B: Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages The policies of insurance listed belowliave been issued to ft insured named above for the policy period indicated.Notwithstanding any requirement tens or condition of any contract or other docurnentwith 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. INSR ADDL Policy Effective Policy Expiration Date Limits LTR INSRD Type of Insurance Policy Number Date (MM/DD/YY) (MM/DD/YY) GENERAL LIABILITY Each Occurrence 5 Commercial General Liability Damage to rented premises(EA Claims Made 11 Occur occurrence) 6 Med Exp Personal Adv Injury PUerneral aggregate limit applies per: General Aggregate Policy ❑Project 11LOCProducts-Comp/Op Agg TOMOBILE LIABILITY Combined Single Limit (EA Accident) 6 Any Auto Bodily Injury All Owned Autos (Per Person) Scheduled Autos Hired Autos Bodily Injury Non-Owned Autos (Per Accidem) Property Damage (Per Accident) EXCESS/UMBRELLA LIABILITY Each Occurrence ROccur ❑Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2013 01/01/2014 X WC Statu- DTH- Employers'Liability I tory Limits ER Any proprietor/partner/executive officer/member E.L.Each Accident $1,000,000 excluded? NO E.L.Disease-Ea Employee sl,000,aoo If Yes,describe under special provisions below. E.L.Disease-Policy Limits $1,000,000 Other Lion Insurance Company is A.M.Best Company rated A-(Excellent). AMB#12616 Descriptions of Operations/LocationsNehicles/Exclusions added by EndorsementlSpecial Provisions: Client ID: 82-65-156 Coverage only applies to active employee(s)of South East Employee Leasing Services,Inc.that are leased to the following"Client Company": A Roofing Specialist,Inc. Coverage only applies to injuries incurred by South East Personnel Leasing,Inc.&Subsidiaries active employee(s) ,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 02-26-13(TLD) Be in Date: 1/7/2012 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPT Stroud anyof the above described policies becancelled before the expiration date thereof,the issurg ireurerwitl endeavor to mail 30 days written notice tothe certificate colder 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. 10050 NE 2ND AVE MIAMI SHORES, FL 33138 i RICK SCOTT, GOVERNOR r - KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION - CONSTRUCTION-INDUSTRY LICENSING BOARD ,CCC057190 The ROOFING CONTRACTOR - y Named below ITCERTIFIED I Under the provisions of Chapter.489.FS` •`.' ��° � ..� Expiration date:-AUG"31, 2018 - �,.� ""� y '� `' ' ` "�;` `"°�� � DALEY„DANIEL P �- -- .. _— J �.'”". �W� �. ❑ Q �4 D"ALEY ROOFING:ING Yi -�i78*NE'106TFi-STR '� 'r' = MIAMI`SHORES—JTFL 3138--_4. _ ----- --.,.--^+•.�_c�—.� -�-L-- - �� ISSUED: 08/30/2016 DISPLAY AS REQUIRED'BYCAV4y SE Q# 1 08300002253 f� Local Business Tax Receipt Miami-Dade County, State of Florida -THIS IS NOT A BILL-DO NOT PAY 3311610 BUSINESS NAME/LOCATION DALEY ROOFING INC RECEIPT"°. EXPIRES MI 106 ST RENEWAL SEPTEMBER 30, 2017 MIAMI SHORES FL 33138 3449899 Must be displayed at place of business Pursuant to County Code Chapter 8A-Art.9&10 OWNER DALEY ROOFING INC SEC.TYPE OF BUSINESS 196 Worker(s) CCC 5P CI LTY BUILDING CONTRACTOR PAYMENT RECEIVED BY TAX COLLECTOR $45.00 09/09/2016 ThisThis Local Business Tax Receipt only confirms aocal CHECK21-16-121507 or a certification of the holder's ualificpaym,t f t business. Holder must comply n9 rnmeutel regulatory laws and reyuir menta which a ply to the business.Business Tax.The Receipt is not a license, or no ove p y with any governmental The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec ea-276. For more information,visit wwi y,mia al vehicles s- �� + r � .a�WRW. JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 7/21/2015 EXPIRATION DATE: 7/20/2017 PERSON: DALEY. DANIEL P FEIN: 650491667 BUSINESS NAME AND ADDRESS: DALEY ROOFING INC 78 NE 106 STREET MIAMI SHORES FL 33138 SCOPES OF BUSINESS OR TRADE: LICENSED ROOFING CONTRACTOR Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S..Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation d,at any time after the thing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 OR X51 1E$G 110,1 Miami shores Village " tea Building Department l0)ltt 10050 N.E.2nd Avenue Miami Shares, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner -- Workers' Com ensation 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. 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 year,,,, or until a voluntary revocation is Bled 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 ACKNONVLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: _X&A, CLS Owner State of Florida County of Miarni-Dade The foregoing was acknowledge before the flush day ofC�� ,20 ; 8y who is personally known tome or has produced as identification: Notary:� Notary pUbjum State of Arimna SEAL: Maricopa County I@ AL A. Diane Ferguson My Commission Expires 052512020 f'q 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-186473 Permit Number: RF-2-13-399 Scheduled Inspection Date: May 10, 2013 Permit Type: Roof Inspector: Bruhn, Norman Inspection Type: - Owner: LOUGHLIN, MARGERY& FRANK Work Classification: Tile Job Address: 1075 NE 96 Street Miami Shores, FL Phone Number Parcel Number 1132060143690 Project: <NONE> Contractor: A ROOFING SPECIALIST INC Phone: (954)966-1185 Building Department Comments RE-ROOF TILE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed V � Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. May 10, 2013 For Inspections please call: (305)762-4949 Page 4 of 21 Phone 954-784-2941 [A era 800-848-1919 Fax 954-784-7875 & TESTING250 SW 13th Ave Pompano Beach,FL 33069 fed-eng.com April 23,2013 Order# 13-1140 A Roofing Specialist 911 South 58th Street Hollywood, Florida 33023 RE: TAS-106 TILE UPLIFT TESTS Proposed Roof/Laughlin Residence 1075 NE 96th Street Miami Shores, Florida Dear Sirs: In accordance with your authorization, Federal Engineering&Testing, Inc has performed Tile Uplift Testing in compliance with Testing Application Standards TAS-106 and the Florida Building Code High Velocity Hurricane Zone on April 23, 2013 at the above referenced project. The purpose of our inspection was to determine the uplift capacity of the roof tiles for the residence at the above referenced project. The subject roof consisted of Flat Concrete Tile Foam Set. The pitch of the subject roof is 3/12. Our field engineer visited the site and conducted 128 uplift tests on the roof tiles. All tests were performed according to the Florida Building Code High Velocity Hurricane Zone and protocol TAS-106 using an Intercomp Scale Model CS200. The following is a summary of results: Field Test Results Test Number Test Location Field Uplift Pull Test Test Result 1 - 14 Corner See Attached Diagram >35 pounds Passed 15—77 Field See Attached Diagram >35 pounds Passed 78 - 111 Perimeter See Attached Diagram >35 pounds I Passed 112— 128 Hip/Ridge See Attached Dia am >35 pounds Passed Keith LeBlanc,P.E. Federal'Engineering&Testing,Inc MIAMP Construction Material Army Corp American Concrete Miami Dade Florida Department Engineering Council of Engineers Institute County of Transportation t Page 2 4/23/13 1075 NE 96`e Street Miami Shores,Florida All test results were found to be in compliance with TAS-106 and the Florida Building Code. The test results are limited to the tested areas. If other roof areas exhibit different conditions, it should be brought to our attention for remedial work. This uplift test is not a roof top inspection. A final roof inspection must be conducted by the building official for approval. The test results presented reflect the condition of the roof system at the time of the test. These results are time and sample dependent since roof conditions are continuously changing due to exposure to the elements. Federal Engineering & Testing, Inc is an independent third party providing un-biased testing information and results. Federal Engineering & Testing, Inc is a third party and is not affiliated with our client nor do we have any financial interest in the project or determination of the test results. As mutual protection to clients, the public and ourselves, all reports are submitted as the confidential property of clients, and authorization for publication of statements, conclusions or extracts from or regarding our reports is reserved pending our written approval. Federal Engineering & Testing, Inc appreciates the opportunity to be of service to you at this phase of your project. If you have any questions or comments, please give us a call. We would be pleased to help in any way we can. It has been a pleasure working with you and look forward to doing so again in the near future. Sincerely, Keith LeBlanc, P.E. Federal Engineering&Testing, Inc Florida Reg. No. 59394 Certificate of Authorization# 5471 Miami-Dade County Certification# 11-0407.01 S �. 12 0. �l 7, q 2 0 • I � q i Ir 076 F j A=O.1 W=0.1x50'=5.0' C. A=0.4H=0.4x121=4.8' Perimeter Dimensions=5.0' Corner area=200 S.F.8 tests a tl Perimeter area=1255 S.F.40 tests Qy' ` Field Sketch Field area=2545 S.F.-20 test I Not to Scale 230 Total Ridge Caps=12 test 1075 NE 96th Street Miami Shores, FL FN 2013RO179010 NOTICE OF COMMENCEMENT ORBk 28519 Ps 4371; (Ips) A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION RECORDED 03/07/2013 10.32:48 HARVEY RUVINr CLERK. OF' COURT �( MIAMI-DADE COUNTYr FLORIDA 3 PERMIT NO. TAX FOLIO NO. ' _ 3a0� U 7" 1b PAGE STATE OF FLORIDA: ,TATE OF FLORIDA.COUNT OF DADS co COUNTY OF MIAMI-DADE: i HEREBY CERTIFY that this is 3 true copy of the G Y! .e original filed in this office on day o! u N THE UNDERSIGNED hereby gives notice that improvements will be m FN a I , A 20 _ and in accordance with Chapter 713, Florida Statutes, the PigIt"fflci l at N000.�+• property, is provided in this Notice of Commencement. HARVEY CLERK,of ndcountyCourts D.C. 6y p •1. Legal description o�r pserty and street address- M ltd m � T XAXIA ARNOLD I l ., '20/ E, K 2. Description of improvement: 3. Owner(s) name and address: _ lolls PC Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: W O 5. Surety: (Payment bond required by owner from contractor, if any) Name and Address: Amount of bond $ 6. Lender's name and address: 1 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes. Name and Address: tj 1,49- 8. In addition to himself, Owners designates the following person(s)to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and Address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) 5 aturOwner y t Print Owner's Name i^ G 0 u r I Prepared by Sworn to and subscribed before me this o� b day of _, 20 13 Address: Notary Public: Print Notary's Name: My commission expires: - °`, MARILYN ANN CASANOVA MY COMMISSION#EE 016581 * * EXPIRES:September 19,2014 m,��eoF F�oeOt Bored Thru Budget Notary Services Section A/B MIAW Miami-Dade County HVHZ Electronic Roof Permit Form "Deliverin Excellence Ever Day" 7BY C�° IVg Y YSection A (General Information) B 21 2013 Master Permit No: Process No: Contractor's Name: 0 �IJ�9 S C� Job Address: o l S 1113f, C16 ST• M 1 Arnm 1 S Nv R 6 Roof Category ❑ Low Slope ❑ Mechanically Fastened TileMortar/Adhesive Set Tile [) .asphaltic Shingles ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes ❑ Sprayed Polyurethane Foam ❑ Other: ,�� Roof Type El New Roof L4� Re-Roofing ❑ Recovering ❑ Repair ❑ Maintenance Are there Gas Vent Stacks located on the roof? ❑ Yes K o If yes, what type? ❑ Natural ❑ LPGX Roof System Information Low slope roof area (ft.2) 7 Steep Sloped area (ft.2)I 3SM Total(ft.2)1 3 STO 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. Perimeter Width (a'):E::::::1 Corner Size(a' x a'):E:::7 t� PERMIT #: V am Shores V•11age APPRO'vED BY DATE 7CNING DEPT KDG DEPT ��lJ SUB„ECT 10 C(,VPI.VNCE wi rH ALL FEDERAL �T�TE AN,CUiN f HUES AND RFGULVIONS k �r { .Y z� f 4' Fla Sort 1' r, in GooSle.-earth Go C)SIC earth feet 80 meters 20 3sb� S . F. �� Tile Poof System MIAMF Miami-Dade County HVHZ Electronic Roof Permit Form Section D Tile Roof System "Delivering Excellence Every Day" Roof System Manufacturer: {� Notice of Acceptance Number(NOA): to-o80 . 1 Minimum Design Wind Pressures,If Applicable(from RAS 127 or Calculations): P1• P2• P3• Maximum Design Wind Pressures,(From the NOA Specific system): psf Fill in the speck roof assembly components.ff a component is not required,insert not applicable(n/a)in the text box. Deck T e: --Select Deck Type- Optional Insulation: Optional Nailable Substrate: N Optional Nailable Substrate Attachment: Roof Slope: "/12" Roof Mean Height: ft. Basesheet Type: Method of Tile Attachment: �© --Select Tile Attachment-- m 90 ✓I (00Fastener Type for Basesheet Attachment: Alternate Method of Tile Attachment per NOA: N A ((S I/J 177 C&P 1J I Pr61 1 O ,G. LP PS MZ11 D— 2u 3, 3„ dTile Undedayment(Cap Sheet)Type: qcL - 90 Drip Edge Size&Gauge: --Select Metal Gauge-- Tile Underlayment Attachment Method: Drip Edge Material Type: --Galvinized etal-- n -T- Drip Edge Fastener Type: 1 S •N Pr ILS Tile Profile: PLftmymoOFLS Hook Strip/Cleat gauge or weight: --Select Hook Strip-- N I -FIC Section E t MIAMI Miami-Dade County HVHZ Electronic Roof Permit Form "Delivering Excellence Every Day" Section E (Tile Calculations) Method 1 "Moment Based Tile Calculations Per RAS 127" For Moment based the systems,use Method 1. Compare the values for Mr with the values from Mf. If the Mf values are greater than or equal to the Mr values,for each area of the roof,then the tile attachment method is acceptable. P 1: XX 30 -Mg:M, =Mr1: 3,5( 5 NOA Mf P 2: x X �,9�9; _®-Mg: Tq =Mr2: 5 �1� NOA Mf P 3: (00, x X -Mg: =Mr3: 5 NOA Mf Method 3"Uplift Based Tile Calculations Per RAS 127" For Uplift based tile systems use Method 3.Compare the values for F'with the values for Fr. If the F'values are greater than or equal to the Fr values,for each area of the roof,then the tile attachment method is acceptable. P1: x1: xw: = -W: xCos 0:E:l=Fr1: 5NOA F' P2:® "1:�=�xw:�= -W:�= xCos 0:1:1=F2:®5® NOA F' P&X1: =�"w:�= -W:�= xCos.:M=Fr3: :5 NOA F' Where to Obtain Information to complete tile calculations Where to Find Description Symbol Design Pressure P1 or P2 or P3 Table 1 RAS 127,or by an engineer analysis prepared,signed and sealed by a professional engineer based on ASCE 7. Mean Roof Height H Job Site Roof Slope 0 Job Site Aerodynamic Multiplier X Product Approval(NOA) Restoring Moment due to Gravity Mg Product Approval(NOA) Attachment Resistance Mf Product Approval(NOA) Required Moment Resistance Mr Calculated Minimum Attachment Resistance F' Product Approval(NOA) Required Uplift Resistance Fr Calculated Average Tile Weight W Product Approval(NOA) I=length Product NOA Tile Dimensions w=width Approval(NOA) MIAM14 MIAMI-DADE COUNTY,FLORIDA M METRO-DADE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER STREET,SUITE 1603 PRODUCT CONTROL DMSION MIAMI,FLORIDA 33130-1563 (305)375-2901 FAX(305)375-2908 NOTICE OF ACCEPTANCE (NOA) Entegra Roof Tile,Inc. 1289 NE 91h Ave Okeechobee, FL.34972 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA) to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Plantation Roof Tile LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and following statement: "Miami-Dade County Product Control Approved",unless otherwise noted herein RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any product, for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This renews NOA No. 09-0803.02 and consists of pages 1 through 5. The submitted documentation was reviewed by Alex Tigera. NOA No.: 10-0804.15 Expiration Date: 12/08/15 MIAWADECOUNTY Approval Date: 10/20/10 Page I of 5 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Concrete 1. SCOPE: This renews a roofing system using Entegra "Plantation" concrete roof tile, as manufactured for Entegra Roof Tile, Inc. in Okeechobee, FL as described in Section 2 of this Notice of Acceptance. For the locations where the pressure requirements, as determined by applicable Building Code, does not exceed the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION: Manufactured by Test Product Applicant Dimensions Specifications Description Plantation Tile Length: 16'/z" Flat concrete roof tile for direct deck or Width: 13" TAS 112 batten nail-on. Trim Pieces Length: varies Accessory trim,concrete roof pieces for Width: varies TAS 112 use at hips,rakes ridges and valley Thickness: varies terminations 3. LIMITATIONS: 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications,a static field uplift test in accordance with TAS 106 may required,refer to applicable building code. 3.3 Applicant shall retain the services of a Miami-Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112,appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. 4. INSTALLATION: 4.1 Entegra Roof Tile,Inc.'s Plantation Flat Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118,119,& 120 4.2 Data For Attachment Calculations NOA No.: 10-0804.15 Expiration Date: 12/08/15 MLAM orwe CO Approval Date: 10/20/10 "�11;10:16rjm Page 2 of 5 Table 1: Average Weight(W) and Dimensions (1 x w ) Tile Profile Weight-W (Ibf) Length-I (ft) Width-w (ft) Plantation Tile 11.6 1.375 1.08 Table 2: Aerodynamic Multi liens - ft3 Tile X(ft3) X(ft3) Profile Batten Application Direct Deck Application Plantation Tile 0.267 0.289 Table 3: Restoring Moments due to Gravity- M (ft-lbf) Tile 3": 12" 4": 12" 5": 12" 6": 12" 7": 12"or Profile reater Battens Direct Battens Direct Battens Direct Battens Direct Battens Direct Deck Deck Deck Deck Deck Plantation Tile 1 6.85 7.79 1 6.75 7.67 6.61 7.52 6.44 7.32 6.26 N/A Table 4: Attachment Resistance Expressed as a Moment - Mf(ft-lbf) For Nail-On Systems Tile Fastener Type Direct Deck Direct Deck Battens Profile (Min 15/32" (Min. 19/32" plywood) plywood) Plantation Tile 2-10d Ring Shank Nails 30.9 38.1 17.2 1-10d Smooth or Screw 7.3 9.8 4.9 Shank Nail 2-10d Smooth or Screw 14.0 18.8 7.4 Shank Nails 1 #8 Screw 30.8 30.8 18.2 2#8 Screw 51.7 51.7 24.4 1-10d Smooth or Screw 24.3 24.3 24.2 Shank Nail Field Clip) 1-10d Smooth or Screw 19.0 19.0 22.1 Shank Nail Eave Clip) 2-10d Smooth or Screw 35.5 35.5 34.8 Shank Nails Field Clip) 2-10d Smooth or Screw 31.9 31.9 32.2 Shank Nails Eave Clip) 2-10d Ring Shank 50.3 65.5 48.3 Nails' 1 Installation with a 4"tile headlap and fasteners are located a minimum of 2'/2"from the head of tile. NOA No.: 10-0804.15 Eoaue counirr Expiration Date: 12/08/15 I�IAPPROVEDI Approval Date: 10/20/10 Page 3 of 5 Table 5: Attachment Resistance Expressed as a Moment Mf(ft-lbf) For Two Patt Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Plantation Tile Adhesive 31.3 2 See manufactures component approval for installation requirements 3 Flexible Products Company TileBond Average weights per patty 13.9 grams. Polyfoam Product, Inc.Average weight per patty 8 grams. Table 6: Attachment Resistance Expressed as a Moment - M, (ft-lbf) For Sin le Patty Adhesive Set System Tile Profile Tile Application Minimum Attachment Resistance Pol ProTm 118.9 Plantation Tile Pol ProTm 40.4 4 Large paddy placement of 45 grams of Pol Pro TM'. 5 Medium paddy placement of 24 grams of Pol ProTM. Table 7: Attachment Resistance Expressed as a Moment- Mf(ft-lbf) for Mortar Set Systems Tile ProfileTile Application Attachment Resistance Seespecific mortar manufacturer's Notice of Acceptance. 5. LABELING 5.1 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo as seen below or following statement: "Miami-Dade County Product Control Approved". 5.2 Entegra Roof Tile, Inc.'s Plantation Roof Tile bears the following markings: USA "E" USA,"E",Entegra"E", where the E is a stylized logo. 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable Building Code in order to properly evaluate the installation of this system. 7. MANUFACTURING LOCATIONS 7.1 Okeechobee,FL NOA No.: 10-0804.15 Expiration Date: 12/08/15 MIAMMADECOUNTY Approval Date: 10/20/10 Page 4 of 5 PROFILE DRAWING PLANTATION FLAT CONCRETE TILE END OF THIS ACCEPTANCE NOA No.: 10-0804.15 MIAMI.OIADE COUNTY Expiration Date: 12/08/15 , Approval Date: 10/20/10 Page 5 of 5 MIAMI' A ANII DADS COUNTY R-=0 - PRODUCT CONTROL SECTION DEPARTMENT OF PERwffrn NG,ENVIRONMENT,AND REGULATORY AFFAIRS(PERA) 11805 SW 26 Street,Room 208 BOARD AND CODE ADMINISTRATION DIVISION Miami,Florida 33175-2474 T(786)315-2590 F(786)315-2599 NOTICE OF OF ACCEPTANCE�OA),nvw.miamia2deeoy/yevivw•rtuamid2deeoy/vera 3M Company 3M Center Building 0220-05-E-06 St.Paul,MN.55144-1000 SCOPE: This NOA is being issued under the applicable rules and regulations governitig the use of construction materials.The documentation submitted has been reviewed and accepted by Miami-Dade County PERA-Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Control Section (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke,modify, or suspend the use of such product or material within their jurisdiction. PERA reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein,and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION:3Mrm 2-Component Foam Roof Tile Adhesive AH-160 LABELING:Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and following statement:"Miami Dade County Product Control Approved",unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any product,for sales,advertising or any other purposes shall automatically terminate this N04k.Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official This renews and revises NOA#11-0124.04 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. NOA No.:12-022818 haAMFD�eCotlNiY Expiration Date:05/10/17 Approval Date:05/10/12 Page 1 of 7 t ROOFING COMPONENT APPROVAL: Category: Roofing E Sub Category: Roof tile adhesive Materials: Polyurethane SCOPE: This approves 3MTM 2-Component Foam Roof Tile Adhesive AH-160 as manufactured by 3M Company as described in Section 2 of this Notice of Acceptance.For the locations where the design pressure requirements,as determined by applicable building code,does not exceed the design pressure values obtained by calculations in ; compliance with Roofing Application Standard RAS 127,for use with approved flat,low, and high profile roof tiles system using 2-Component Foam Roof Tile Adhesive AH-160.Where the attachment calculations are done as a moment based system for single patty placement,and as an uplift based system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test Product Description Specifications 3MTu 2-Component Foam N/A TAS 101 Two component polyurethane foam adhesive Roof Tile Adhesive AH- 160 - ` Foam Dispenser RTF1000 N/A Dispensing Equipment f ProPack®30& 100 N/A Dispensing Equipment k PRODUCTS MANUFACTURED BY OTHERS: Any Miami-Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment resistance values with the use of 2-Component Foam Roof Tile Adhesive AH-160 roof file adhesive. , MANUFACTURING LOCATION: 1. Tomball,TX. PHYSICAL PROPERTIES: ProveProverty Test Results Density ASTM D 1622 1.61bs./ft.3 Compressive Strength ASTM D 1621 18 PSI Parallel to rise 12 PSI Perpendicular to rise Tensile Strength ASTM D 1623 28 PSI Parallel to rise Water Absorption ASTM D 2127 0.08 Lbs./Fe Moisture Vapor Transmission ASTM E 96 3.1 Perm/Inch Dimensional Stability ASTM D 2126 +0.07%Volume Change @-40°F.,2 weeks +6.0%Volume Change @1580F., 100%Humidity,2 weeks Closed Cell Content ASTM D 2856 86% NOA No.:12-0228.18 Expiration Date:05/10/17 MIAMFQADE COUNTY JAPPROVEDI Approval Date:05/10/12 Page 2 of 7 Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variation. EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Reuort Date Center for Applied Engineering #94-060 TAS 101 04/08/94 257818-IPA TAS 101 12/16/96 25-7438-3 SSTD 11-93 10/25/95 25-7438-4 25-7438-7 SSTD 11-93 11/02/95 25-7492 SSTD 11-93 12/12/95 Miles Laboratories NB-589-631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories,Inc. 9637-92 ASTM E 108 04/30/93 Southwest Research Institute 01-6743-011 ASTM E 108 11/16/94 01-6739-062b[l] ASTM E 84 01/16/95 Trinity Engineering 7050.02.96-1 TAS 114 03/14/96 Celotex Corp.Testing Services 528454-2-1 TAS 101 10/23/98 528454-9-1 528454-10-1 520109-1 TAS 101 12/28/98 520109-2 520109-3 520109-6 520109-7 520191-1 TAS 101 03/02/99 520109-2-1 LIMITATIONS: 1. Fire classification is not part of this acceptance.Refer to the Prepared Roof Tile Assembly for fire rating. 2. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 shall solely be used with flat,low,&high tile profiles. 3. Minimum underlayment shall be in compliance with the Roofing Application Standard RAS 120. 4. Roof Tile manufactures acquiring acceptance for the use of 3MTM 2-Component Foam Roof Tile Adhesive AH- 160 roof file adhesive with their tile assemblies shall test in accordance with TAS 101. 5. Roof Tile manufactures acquiring acceptance for the use of HANDI-STICK roof tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. F _ W 2 F'= MS NOA No.:12-0228.18 MIAMFD1IDE COUNTY Expiration Date:05/10/17 ]APPROVEDI Approval Date:05/10/12 Page 3 of 7 INSTALLATION: 1. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of 3MTM 2-Component Foam Roof Tile Adhesive AH-160. 2. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of 3MTM 2-Component Foam Roof Tile Adhesive AH-160 shall provide sufficient attachment resistance,expressed as an uplift based system,to meet or exceed the uplift resistance determined in compliance with Miami-Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA. 3. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 and its components shall be installed in accordance with Roofing Application Standard RAS 120,and 3M Company's 3MTM 2-Component Foam Roof Tile Adhesive AH- 160 Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained'Qualified Applicator'approved and licensed by 3M Company. 3M Company shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the Foam Dispenser RTF 1000 dispensing equipment is required before application of any adhesive. The mix ratio between the"A" component and the"B"component shall be maintained between 1.0-1.15(A): 1.0 (B). The dispense timer shall beset to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 shall be applied with Foam Dispenser RTF1000 or ProPack®30& 100 dispensing equipment only. 7. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive.Tile must be set within 2 to 3 minutes after 3MTM 2- Component Foam Roof Tile Adhesive AH-160 has been dispensed. 9. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 placement and minimum patty weight shall be in accordance with the Tlacement Details'herein. Each generic tile profile requires the specific placement noted herein. Table 1:Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Single Paddy Weight Two Paddy Weight per Min.(grams) paddy Min.(grams) Flat,Low,High Profiles #1 35 N/A High Profile(2 Piece Barrel) #1 17/side on cap and 34/ an N/A Flat,Low,High Profiles #2 24 N/A Flat,Low,High Profiles #3 1 8 NOA No.:12-0228.18 MIAMI•DeADE COUNTY Expiration Date:05/10/17 _IAPPROVEDI Approval Date:05/10/12 Page 4 of 7 • l i LABELING: All 3MTM 2-Component Foam Roof Tile Adhesive AH-160 containers shall comply with the Standard Conditions listed herein. BUILDING PERMIT REQUIREMENTS: j As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. I ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY Nail through plastic caned Paddy(Beneath Tile) Nail through plastic eemad Paddy(Beneath Tile) Underiayment Underlayment loin to >_ ! 1%�ln�. , i 2 = Ears course = Fascia 6Ye CON Fascia Weephole Em course o* ( Fm Comae ody: Em dos= Keep Eave mm s 4pup fromm from I 4 asW approx. Keep alhesin W- Drip edge w"holes Nail through plasticartmd Paddy(Bemialh Tile) 1)Place enough adhe"lo achieve 17 to 23 mond 2:4 sfor square indrss incental wdh the pm tMh s"pl�appicetlorrs Nall through pWatic cement - 4ToIIn�F u�ido�Pof�ML 112 in Then hold iM tge, o underlaymed j>f>` 10 In. 2 m - o EmCcurse EaveCiomn = Eris course as ffte��spprm/h aP FasciaMrs amacersrlM Abut tosecond,oaraof Qpgonal pm Wn.Eromsavesndol pm cerci eovmtges an POW-up Naft en bipAudnsl t qrs edges oftile Wasphole Freda f ' I NOA No.:12-0228.18 MIAMWiADE COl1N1Y i Expiration Date:05/10/17 APPROVED1 Approval Date:05/10/12 Page 5 of 7 I ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY Nag through plastic cement Paddy(Beneath Tile) Nail through plastic cement Paddy(Beneath Tib) Undedaymerd •� Undedaymad 71 i 2 in. -- • =-=== 71n. Alin. _ Em Comm Fesda Fascia Weephob Eave Course Eave closure Em Closure Drip edge Nall through plastic cement paddy(Beneath Tile) Undedayment - 7 in. viz in. -- Eave Closure El"Course Fascia NOA No.:12-0228.18 IRMECCUM Expiration Date:05/10/17M = Approval Date:05/10/12 Page 6 of 7 ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Nall through plastic cement Paddy Nail through plastic cement Single paddy under file (between Ole) Undedayment Single paddy between go I'My 2 h x 71n.medlum under tile) sae paddy save course only Ingle paddy n.x 3 In. 31n undertile x 3 in. Sine 4 in. 2 In. g Single paddy on 2 in. 41 paddyon laym!nt under- layment Single paddy Fascia Fane Course on top of tile Weepliole Single paddy In.X 7 In.medium Eve Em closure on I of size paddy save % course Fascia course only Drip edge Nall through plastic cement Single paddy under Ole Single paddy between tile 3 In.x 3 In. 41n. Single paddy on undedayment 2 n. Single paddy EmCMn on top of the 2hx7hmedium Em CoupeFasciasize paddy save course only END OF THIS ACCEPTANCE NOA No.:12-0228.18 MLOWN)ADECOUNTYM Expiration Date:05/10/17 Approval Date:05/10/12 Page 7 of 7 OR 114C I% u C1 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: C eC PERMIT# 6�f 1 ADDRESS: IOM w C- • 16" st Hiram shotes FL 3313) FOLIO NUMBER: i 1 -3 20Gd I q- 3 6-10 FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS(12 MONTHS): COST OF PROPOSED IMPROVEMENTS: � � Io o O •° a . (ATTACH COPY OF CONTRACT) TOTAL CUMULATIVE COST OF IMPROVEMENTS(past and proposed): �1�1 600 ,©o VALUE OF PRINCIPAL STRUCTURE(attach appraisal): ` 1 / / �of N 3 .OWNERS SIGNATURE: � DATE/ -,2,4 PLAN REVIEWER SIGNATURE: DATE: Created on June 2009 MIAMI-DADE COUNTY ' OFFICE OF THE PROPERTY APPRAISER PROPERTY SEARCH SUMMARY REPORT Carlos Lopez-Cantera ' Property Appraiser Property Information: 4 Folio 11-3206-014-3690 Property Address 1075 NE 96 ST Owner Name(s) MARGERY LOUGHLIN Mailing Address 1075 NE 96 ST MIAMI FL 33138-2551 Primary Zone 1400 SGL FAMILY-3001-3250 SQ Use Code 0001 RESIDENTIAL-SINGLE FAMILY Beds/Baths/Half 2/2/0 - ^j f r Floors 1 r Living Units 1 Adj.Sq.Footage 2,319 Lot Size 12,375 SQ FT j { R Year Built 1948 Legal Description 5-6 53 42 A Aerial Photography 2012 MIAMI SHORES SEC 3 PB 10-37 LOT 9&E1/2 LOT 10 BLK 82 LOT SIZE 75.000 X 165 Taxable Value Information: OR 00000-0000 0799 01 Current Previous Assessment Information: Year 2012 2011 Current Previous Exemption/Taxable Exemption/Taxable Year 2012 2011 County $50,500/$103,417 $50,500/$98,934 Land Value $148,050 $141,000 School Board $25,500/$128,417 $25,500/$123,934 Building Value $177,999 $178,018 City $50,500/$103,417 $50,500/$98,934 Market Value $326,049 $319,018 Regional $50,500/$103,417 $50,500/$98,934 Assessed Value $153,917 $149,434 Sale Information: Exemption Information: Date Amount Recording Qualification Code Book-Page Current Previous 7/1999 $0 00000-0000 Sales which are disqualified as Year 2012 2011 a result of examination of the deed Homestead $25,000 $25,000 7/1972 $49,900 00000-0000 Sales which are qualified 2nd Homestead $25,000 $25,000 Senior $0 $0 Veteran Disability $0 Civilian Disability $0 $0 Widow(er) $500 $500 Disclaimer: The Office of the Property Appraiser and Miami-Dade County are continually editing and updating the tax roll and GIS data to reflect the latest property information and GIS positional accuracy. No warranties,expressed or implied,are provided for data and the positional or thematic accuracy of the data herein,its use,or its interpretation. Although this website is periodically updated,this information may not reflect the data currently on file at Miami-Dade County's systems of record. The Property Appraiser and Miami-Dade County assumes no liability either for any errors,omissions,or inaccuracies in the information provided regardless of the cause of such or for any decision made,action taken,or action not taken by the user in reliance upon any information provided herein. See Miami-Dade County full disclaimer and User Agreement at http://www.miamidade.gov/info/disclaimer.asp. Property information inquiries,comments,and suggestions email: pawebmail@miamidade.gov GIS inquiries,comments,and suggestions email: gis@miamidade.gov Generated on:Tuesday,February 26,2013 A Roofing Specialist, Inc. Licensed & Insured CCC#1327880 911 South 58`h Ave. Unit A www.arOOfingspecialist.COm Broward: (954) 966-1185 Hollywood, FL 33023 Palm Beach: (561) 241-9137 Miami: (305) 377-0440 � CONTRACT AGREEMENT Fax: (954) 989-5359 Dat CONTRACT SUBMITTED TO: WORK TO BE PERFORMED AT: Name: Address: Address: ity: City: Date• Telephone: Telephone: We hereby propose to furnish all materials and perform all labor necessary for the completion of type of leak or roof as described below: V t Lob A Cape 4 TOTAL . WORK COMPLETED BY: `- r'00' — DEPOSIT: DATE: 2ND DEPOSM. _ � DATE: '� BALANCE DUE Ile UPON COMPLETION: DATE ACCEPTED: ACCEPTA/EOF.CONTRACT PARTS ONE AND TWO �J CUSTOMER: r SALESPERSON:_'/I /� /e A Roofing Speciali , Inc.shat of bresponsible or damages or delays,either before commencement of or during the said work described, or after work is completed, herein on account of transportation difficulties, priorities, strikes, accidents, war, acts of God, fire, sudden rains, hurricanes, tornadoes, storms,windstorms, other casualty,theft or other causes beyond its control.These acts will null and void said warranty. I A ROOFING. SPECIALIST, Estimate 911 S 58th Avenue #A Date Estimate # Hollywood, FL 33023 2/25/2013 P 13-214 Name / Address Margery Loughlin 1075 NE 96th Street Miami Shores, FL 33138 Project Description Total NEW TILE ROOF : 24,600.00 1.) Remove Existing Roof and Dispose. 2.) Replace any rotted wood up to 300 feet, additional at $3.00 a Foot. 3.) Install 30 LB Base Sheet w/Ring Shank Nails 4.) Install Drip Edge Valley Metal , PVC Boots, Exhaust Vents 5.) Install 90 LB. Mineral Surface cap sheet in Hot Asphalt 6.) Set tile in Tile Foam Adhesive *** 10 YEARS WARRANTY Thank you for your business. Tota $24,600.00 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 item has been pe�,,xplaine d. 1/� � U. Aesthetics-Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Z ne) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance 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 zoning code, should be addressed as part of the agreement between the owner and the contractor. �Z. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed 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). . J. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. 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. .�4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from 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 Florida Building Code provides the option of maintaining this appearance. 2'S. Ponding Water: The current roof system and/or deck of the building may not drain well and may cause 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. V_6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not overloaded 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 overflow scuppers in accordance with the Florida Building Code,Plumbing. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service Iife of the roof. � Owner's/ ` ent'V, gnature Date Contract ell Signa C:IDoeumeab and Sannykpmnu�Y.ml3enlnp�T.mplTempon r}hlmel Fl1ntContmLIEfiOKLBAFTR5EC710Y I514111.4oe