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RF-17-1076 Permit Nd. RF-44 7-1076 Miami Shores Village 'P6' 7# Pe:Root 4y� 10050 N.E.2nd Avenue NE Woik0)essr#o0on,Flat "' Miami Shores,FL 33138-0000 Petmit Status;APPROVED, Fj Phone: (305)795-2204 ORa. Issue Date,0"7 Expiration: 1 /15/2017 Project Address Parcel Number Applicant 150 NE 102 Street 1132060131870 Miami Shores, FL 33138- Block: Lot: DANIEL RODRIGUEZ Owner Information Address Phone Cell DANIEL RODRIGUEZ 150 NE 102 Street MIAMI SHORES FL 33138-2325 Contractor(s) Phone Cell Phone Valuation: $ 8,475.00 PERKINS ROOFING CORPORATION (305)687-6521 (786)277-8486 Total Sq Feet: 1000 Type of Work:Re Roof Available Inspections: Additional Info:REPLACE 2 FLAT ROOFS Inspection Type: Classification:Residential Tin Cap Scanning:3 Final Roof Review Roof Roof in Progress Renailing Affidavit Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Bond Type-Contractors Bond $500.00 Invoice# RF-4-17-63735 CCF $5.40 04/18/2017 Credit Card $50.00 $730.90 DBPR Fee $3.75 DCA Fee $3.75 04/18/2017 Credit Card $230.90 $500.00 Education Surcharge $1.80 04/18/2017 Check*1298 $500.00 $0.00 Permit Fee-New Roof $250.00 Bond#:3380 Scanning Fee $9.00 Technology Fee $7.20 Total: $780.90 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 ELECTRI L,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFI IT: I certify at the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a zo ' g. Fu I a thorize the above-named contractor to do the work stated. April 18, 2017 Audiv6die—d ignature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 18,2017 1 ,v iam! Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (345)795.2204 Fax:(305)756.8972 RE: Permit: '"t'1� �_[d�, DATE Lq 4&/ .2 INSPECTION AFFIDAVIT i _ 1 tic,ia�e r Ll!ftS , licensed as a(nj, nbracter. Engineer I:Architect, (P t name Std drde WM Toe) FS 468 Building Inspector License,* CzcL OLamc,�..� On or about fIQ rnI did PMonally inspect the roof deck narking (ore&ffine) work at ® t (CWOO*JOb SRO Adttresa} Based upon that examination 1 have determined the installation was done according to the Hurricane Mitigation Retrofit Manual(Based on W(&A A .A., 4 .S} r Signature State of Florida County of Dade< The undersk ned,being the first duly swum,deposes and says that WWII,9 is the contractor for the above property mentioned,. Sworn to and subscribed before me thisS day ofAq'If , Bryant Adams Notary Public,Sate of Florida at Large _ ommission#GG094563 = Q1Expires:April 16,2021 °� o���;`O�' Bonded thio Aaron Notary `Gerraral;summ,Raskler�t�1,or R corp sOn Dr any G Stidualt�d under4f8 F S.to make suds an bpeet m induce pho mphs of eaOh pww ofve W*jth permit d and address#dearlyshown M*ed m itre deck. :Jtspedton amaem,s rn nrinronl�Mr�tMrtna f Miami Shores Village RECEIVED Building Department APR 1 2017 10050 N.E.2nd Avenue Miami Shores Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 g- FBC 20�LA BUILDING Master Permit No. :09 1 -7 —1 C5T�o PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 15o 1E,� og City: Miami Shores n' County: Miami Dade zip: Folio/Parcel#: I�� O w'y I ~ D Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: l � OWNER:Name(Fee Simple Titleholder``):_ b6ft k'l 2.j h-, Phone#: Address: 8 City: t Gi State: Zip: Tenant/Lessee Name: Phone#: Email: /' CONTRACTOR:Company Name: L Co Phone#:.7? O,57 Qra Address: 7 City: 3�G � State: � Zip: 3/4.o Qualifier Name: Phone#: State Certification or Registration#: �e ®�g7 dgTe Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address*-- City: State: Zip: Value of Work for this Permit: 14 Square/Linear Footage of Work: /0001--44— Type 0001'C44—Type of Work: ❑ Addition/ ❑ Alteration ❑ New Repair/Replace ❑ Demolition Description of Work: /at roct''.(��� - Specify color of color thru tile: Submittal Fee$ SD' Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ 65b(D f-�0 c TOTAL FEE NOW DUE$ � V' l (Revised02/24/2014) 11-P —j �f0 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 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 on 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. (Z)OCI A A Signature Signature OWNER or AGENT CONTRACTOR The foregoing instru ent was acknowledged before me this The foregoing instrume t was acknowledged before me this day of C�1 20 ,by ��day of -Affil 20 1.7 ,by who is personally known to who is personally known to me or who as produced as me or who has produced as identification and who d«{fake an oath. identification and who did take�fJ o��,anf J. Ae is Y J. Adams �%COMMISSIONI�F., ' NOTARY PUBLI NOTAR UBLIC: .y�4=COMMISSON#FF007880 �Q�'acEXP :APR.I=`., 1� . oee:EXPIRES:APR, '2017 t .�� Rot*cl ,a www. NOTARY.com Sign Sign: ? Print: Print: .7/' J -AW40ea-C Seal: Seal: �ws�x��+ku+k+k*s+�ta**�x*wx�s*�s�►►*+k�*��*�x� �+► *r axe*rts+k��*�r�*.r*�ea�*��rixrr*x+x�M��re�rr�*�*�***�****��rx�***�a****+k*****s*+k 6 `'7 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Miami shores V ..�� Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 38188 Tel; (305) 795.2204 Fax: (305) 756.8972 OWNERS'S A►FFIDA►VIT F EXEMF'110PJ ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EyISTING SITE= BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PRSUANT TO SECTION 553.844 F.S. To. Miami Shares Village Building Department Date: 10050 NE 2NAve Miami Shares,Fl 33138 Re: Owner's Name; D",A;Q,( Propeq Address: AIC Ao.-4-5 Roofin Permit Number: I ar 'ding 0 fficial: I C i certify that l am not required to retrofit the roof to wall connqopns of my building because: } The just valuation for the structure for purpose of ad valorem taxation is less than$300,000.00,Please attach proof of ad valorem taxation. o The building was construed in compliancemith the provisions of the Florida Building Code(FSC)or with the provisions of 1$84 edition of.the South Florida Building Code(1 W SFEC) Signature Print Name State.of Florida County of Dada The undersigned, being'the i~rtst drily swom,deposes and says that helshe.1s the owner for the ab�v e prg�ar� �� r . a ,aaaaa y, Sworn to and subscribed before me this day of f/ ';�`°� .U��-com�a�ssION#FF007aao . EXPIRES:APR.14,2017 �iy,�,ee aaa yyWW.AARONNOTARY.COm Notary Public,Sate of Florida et Largs • When the just vawation.of the sttuchn for'puq of ad.vatarem taxation is egoai to or more than$3tt0,000.00,and ttie rounding was w c;orttnrded wfth PSG nova 1994 5FBC.Than you must provide a bunft appticat from.a Generat Contractorforthe Roof to Wag connection Humane Miradon, Revised on WV2009 Proper Search Application- Miami-Dade County Page 1 of l L F0 K T Y A P Pl"R F oci Summary Report Generated On:4/18/2017 Properly Information Folio: 11-3206-013-1870al� � � � E 150 NE 102 ST Property Address: g € � . Miami Shores,FL 33138-2325 �� E Owner DANIEL M RODRIGUEZ 150 NE 102 ST Mailing Address MIAMI SHORES,FL 33138-2325 PA Primary Zone 1000 SGL FAMILY-2101-2300 SQ ) � 4 0101 RESIDENTIAL-SINGLE ' ,. Primary Land Use f t FAMILY: 1 UNIT Beds I Baths I Half2/2/0 Floors 1 , T L Living Units 1 , � �� E � Actual Area 2,032 Sq.Ft � - „3 � Living Area 1,429 Sq.Ft � Adjusted Area 1,778 Sq.Ft Taxable Value Information Lot Size 11,500 Sq.Ft Year Built 1938 County 2016 2015 2014 Assessment Information Exemption Value $50,000 $50,000 $50,000 Year 2016 2015 2014 Taxable Value 1 $92,022 $91,035 $89,916 Land Value $287,615 $218,776 $218,776 School Board Building Value $121,313 $121,313 $118,172 Exemption Value $25,000 $25,000 $25,000 XF Value $2,044 $1,658 $1,680 Taxable Value $117,022 $116,035 $114,916 _.... ........................................................ ........................................................ City Market Value $410,972 $341,747 $338,628 Assessed Value $142,022 $141,035 $139,916 Exemption Value $50,000 $50,000 $50,000 Taxable Value $92,022 $91,035 $89,916 Benefits Information Regional Benefit Type 2016 2015 2014 Exemption Value $50,000 $50,000 $50,000 Save Our Homes Assessment Taxable Value $92,022 $91,035 $89,916 Cap Reduction $268,950 $200,712 $198,712 Homestead Exemption $25,000 $25,000 $25,000 Sales Information Second Previous Price OR Book- Qualification Description Homestead Exemption $25,000 $25,000 $25,000 Sale Page Note:Not all benefits are applicable to all Taxable Values(i.e.County, 03/01/1993 $105,000 15864 Sales which are qualified School Board,City,Regional). 2596 05/01/1989 $0 00000- Sales which are disqualified as a result Short Legal Description 00000 of examination of the deed MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 8&9BLK14 LOT SIZE 100.000 X 115 OR 15864-2596 0393 1 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property Appraiser and Miami-Dade County assumes no liability,see full disclaimer and User Agreement at hfp://www.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 4/18/2017 s 1A1 a Ur MUMIJA DEPARTMENT OF BUSINESS ANDPROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 251 FLAIR ST }dE ROAD TALLAHASSEE FL 32399- 1783 PERKINS DAN GURTIS PERKINS ROOFING CORPORATION 575 NW 152.STREET MIAMI Fl.33169 Congratulationsl With the license you bis one of the nearly one million Floridians licensed by the errt of Business arty ; Professional Regulation. Our p k*Araa1s and business"range ST TE !F ISL fi-A, from architects to yet broksra;ftm boxers to barbeque �' � 1 EPAR � OSINESS AND, restaurants,and keep;F economy strong. PTS} LCT 1AN Every day we work#►im vie do business in order ( � C to serve you better« donut our services,pisses ' A lin m � x►. #"hererou can find more IER iF1E i € infomiatlon at aut s and tie regulations that Impact _ .. you,subs+ lbe to dn ars and team more about = I� F� Departmenrs in atives. � `t Our rasion at Department Is..License E�icently,Regulate m Fairly.We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Fkmda, osnYr lEC1 under rr x icrn t�f Ch d el 5 and congratulations on your now license; .kr ..... . A w DETACH HERE RICK SCOTT,GOVERNOR KEN LAWSON,SECRETARY mill► OF BUSINEl S Pmt �8i 1�1 1 N -" yy■y �;♦yCTIyy,(, ,y■Y yy CON �7j(pyj.gyyY $�` T r M� 7 .re9a 3e"s t dtl �h#t{acr�epd I ' WM7 y Vit i e�` s� f fit.+*` du f, S O i✓ ,..'., r �� Y, 3s 4 fLE »( L �z §, • Y "4ykw y a _ , �`.'t..,, K kl ? s s 9 ' 3 1��L} Y - }9!!YY ♦♦��yyy.� 2 .wt E r, C1Wi\1i 4 n v": See.TV14.,F�tJ7�i1 ��4ff y PAYMEMf ,00 f3 16 CREDIT 6-0422' . trit a iDt oar of me .E The Necei is aet a lisp, , NGatt#iot;�dolma ._. x�D bus�rW Nn r was Styr dt- Pt*q x �w F+ahB�(toli #stepedanA"amwam fdss �4"'i�. � DATE(MMIDDfl'" .4oY CERTIFICATE OF LIABILITY INSURANCE F 4/12/2017 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 pollcy(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT CT Jeff Lampert Presidential Insurance Services,LLC (0,PHON 305-423-0350 ac N,);305-423-0351 2665 South Bayshore Drive#707 ADDRESS: jeff@insurancequotelive.com Miami, FL.33133 INSURERS AFFORDING COVERAGE MAIC# INSURERA: Preferred Contractors Insurance Company INSURED INSURER B: Perkins Roofing Corporation INSURERC: 575 NW 152 St INSURER D Miami, FL.33169 INSURER E: CCC 042786 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLTYPE OF INSURANCE JKM WVO SUER POLICY NUMBER PMfDQ EFF POLI D EXP LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS MADE OCCUR DAMAGE TO RENTEM-PREMISES Ea occurrence $ 50+000 A PC-77932-07 1/13/2017 1/13/2018 MED EXP Any one person $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY❑JEC FI LOC PRODUCTS-COMP/0P AGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acddent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS f LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Roofing CERTIFICATE HOLDER CANCELLATION Village of Miami Shores Building Dept. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2nd Ave, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE w 49 1 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD .4co►ty® CERTIFICATE OF LIABILITY INSURANCE DA4/13 DD/YYY1f) 4/13/2017 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 pollcy(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 CONTACT TriGen Insurance Solutions, Inc. NAME Chris Rhoden 315 SE Mizner Blvd PHONE (877) 987-4436 FAX EMAIL No:(954) 252-4426 Boca Raton FL 33432 ADDRESS' INSURERS AFFORDING COVERAGE NAIC tt INSURER A:Guarantee Insurance Company 11398 INSURED (248) 971-1030 INSURER B: Trion Solutions, Inc. et al L/C/F Ameritemps Employment II INSURER C: 340 E Big Beaver Road INSURERD: Troy MI 48083 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 19452 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. INSR TYPE OF INSURANCE AD L SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE F OCCUR D S O NTED PREMISES Me occurrence $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JET LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE UA131LITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED P BODILY INJURY(Per accident) $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOSAUTOS Per accident $ L $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY YINWCP500079302GIC 12/31/201612/31/2017 X STATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? F—] N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If Yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space Is required) Coverage is provided to leased employees and not subcontractors or non-leased employees of Ameritemps Employment II. Location coverage effective 12/31/2016. Ref: Perkins Roofing Inc, Employees: Francisco Vasquez, Mauricio Montoya, Jorge Montoya Calderon, Roger Cruz Navas, Georges Lochards, Alex Gonzalez, John Farrell, Dejon Redo, Juan Ortega CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Miami Shores Building Dept. ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Ave AUTHORIZED REPRESENTATIVE Miami Shores FL 33138 ` ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Page 1 of 1 l � RECEIVED ROOF ASS>w ILIES AM fWOMOP,$TffiWWfIES flodcie;Building Code w Edon(20114) i 1 `! h-VoNoe ty Hurn Zone un�if+orm Pe�rWit Application W �;��Cgrtis star CO y . y�:D f R T°Jw ,Ir .le / Job Address l A� 0000 .. 0000 — 0000. /e f ROOF CATEGORY Low Slope 0 IOChanlcally Fastened Tile © Mortar/Adhesive Set %• � 13 Asphe c ShICt Ws © Metal Partel/Shingles -Wood Shirt�es/Sttak'e�t•••• •••�' p Prescriptive S�PAS 1S4` ' •••• ROOF TY Reroofing •••:•• • •• • NOW roof flRepair bRepalr Matnter►anre. ...� � ';��. ... • ROOF SYSTEM INFQR!!1A •� • 0000 0000. Low Slope Rod Area(SIF] Steep Sloped Roof AREA(SSFj Total ( F) 0"Ci •••' •••�•• .09.00 I ' Sketch Roof.Plan-Illustrate all levels and sections roof zlra is 0.4.. 5fons of:s+sons and levels,dea Id ' •scuppers,over#low sca Mrs and®Yerllewpi^elns..ftedirn+ ' ,� OY. wr dlmert$torm of elevated pressure tcr� Ion of p�r'.� 4, .. i 1 t I 1 1 1 k 4 r MOFWA WlW3 G Cl3W—PUILWNO,Stfi 9OMt)R{2018)OftwetS;37 t � � �ttEtterWI, abr> c+urxwn�,amsr�.s��� �ro� Florida Building Code Edition 2010 High Velocity Hurricane Zone Uniform Permit Application Form Section C (Low Sloped Roof System) Fill in Specific Roof Assembly Components Fastener Spacing for Anchor/Base Sheet and Identify Manufacturer Attachment (if a component is not .identify as"NA') System Manufacturer:___ L s+�1 Vie • "oc @ Lap,#Rows @ y "oc NOA No.: �" �� ���7 a oc @ Lap,#Rows ,/'' @ 'oc Design Wind Pressures,From RAS 128 or Calculations: oon Corner: 4V oc @ Lap,#Rows @ "oc Pmaxl: Pmax2: 7J Pmw:/0 Number of Fastener Per Insulation Max.Design Pressure,From the Specific NOA Board System: ".'�r.GR. + •'•••� 6.6.6• Field: Per! •t;�mer •6• •' Deck: /� •• • � ' Type: ...... 6666 660.0• �,/� Illustrate Components NoteJand ••"' Gauge/Fhickness•� /� • • Details as Applicable: •••• lope: f J°. /Z Woodblocking, Gutter, Edgep••4erminaTion, ' �W�. ,tripping, Flashing, Continuoys6•(Meat, Cl'�r�t•'• ...... A�chorrsase Sheet&No.of Ply s): trip. Base Flashing, Co�Lr•6 FlashiitQ, ' • Coping,Etc. •6.6•• • An /B a Sh et E�stensrBoyding Mite ai; Indic : Mean Roof Height, ?arepit Height, • """ 1Tli �4sY`/t/Qtly / K40t1mss Height of Base Flashing, Com�onert Mate4ll"'• :.••.; — Material Thickness. Fastener ;ypv, .Fasts jr. 6 • • Insulation Base Layer: Spacing or Submit Manufacturers•Details that •„ Comply with RAS 111 and Chapter 16. Base insulation Size d Thickness: Base Insulation F tener/Boning Material: eAOTop Insulation or: Top FT Top Insulation Siz nd Thickness: Sy3 Parapet !qty Height Top insulation FastenerBonding Material: il-ad-O-S Base Sheet(s)&No.of Ply(s)._ FT Base Sheet Fastener/Bondi aterial: +'�'j' - Mean Roof Height Ply Sheet(s)&No.of PIy(s)4"5 .5+�3/ Ply Sheet Fastener/Bonding, lUlat�e�r'ralA�y� Top Ply: �fr4S?7aia'GpXr �AF� �`�iF7 Top Ply Fastener/Banding Mat al Surfacing: �� ~ ROOF ASSEWISLiES:AND ROOFTOP STRUCTURES Ffvrlda BufidhV tCode 5th Editioin(20114) 1 High-Velocity Hurricane Unca Uniform Fermtt Application;Form I 1 Section D{steep Sloped Roof System) . 1 Roof System Manufacturer. 1 Notim of Acceptsrtw Number Minimum Design Wind Pressures,if Applicable(Ff'om RAS 127 or C8lculatfonsy � P9; P1: Pi, 1 1 Deck Type: 1' lype tnderlaymenb �1• Roof Slope: ir}saiabon' ...... • �....� Fire Urrier. .... .:..' Rig �ler�tladon? Fastener Type&Spacing: •�•' 1....:. Adhesive Type ...• 1' • Type Cap Sheet: 1 1 Mean Root Height Cou n " Roof eri g: i f Type&Size Drip Edge; 1 ii i FLORIDA BUILDINfit C ODE--BUILDIN9,SEP►EDITION(2014) 15.38 M 1 Copyrigbtta,or"by,ICC(ALLRll3 M R V8D);.nowsse8 by Blew hlado an Jung,201510 *2lc12 AMpmuant to LA=ft A dit.l+Ni furthcr ftp odualans authati" ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Sth Edition(2014) 1 1 High-Velocity Hurricane Zone Unifortnf Perron Application Form.. 1 1 1 Section Iw(Tile Calculations) For Moment based tiw syetems,choose either Method 1 or 2.Compare the values for M with the values from M,,if the M,values 1 are greater than or aqua to the values,for each area of the roof,then the file attachment method is acceptable: 1 Method 1 "Moment Based Tile Calculations Per RAS 127" 1 (P1: x 1 --Mg M„ Product Approval M► (P2: xX = .—iVlg M� Product Approval 1 (P3-=x)._= ._..1 Mg: M. Product,Approval M, 1 Method.2"Simpiified Tile Calculations Per Table Below" 1 Required Moment of Resistance(M)From Table Below Product Approval M, .•••• MTrequired Moment Resistance` •••• ,• i .•.• , Mean Roof Height 15, 20' 2b' 30• ...... 1 Root Slopeo .... ••• 1 2x42 34.4 38.5 38 2 3g,7 ... 2 •• �.... i 3:12 32.2 34.4 306 37.4 . 3 _8 �•.... ..�.. 4.42 30.4 32.2 33.8 35.1 r 5:12 28.4 30.1 31.8 32.8 1 6:12 26.4 28.0 29.4 30.5 •••3 !+� ....:. 7:12 24.4 25.9 27.1 28.2. 30. � • Must be-used in oortijunctlon with a list of moment based clic systems.endorsed by the Broward Co01V$barird of lee%acrd Appeals. .. 1 For Uplift based file systems use Method 3.Comppaared the values for F with the:values for Fr,if the F'values are greater than or I equal to the Fr values,for each area of the roof;then t a Iiia attachment method Is acceptable. 1 Method 3"Uplift Based Tile Calculations Per RAS 12`7"' 1 (P1: x L x w;:=,_j-W: x c oa 9 =F,, Product Approval F'. 1 {P2: x L x w;.= -»'USI: x cos e =F,2_ Product Approval F" I (P3: x L_= x w:___ )_Wt_x cos'9 =F,., Product Approval F' 1 1 Where to Obtain lnformation I Description Symbol Whom to find I Design;Pressure P1 or P2 or P3 RAS 927 Table 1 or by an engineering analysis pre-. pared by Pb based onASCE 7 I Mean Roof Height H Job Site I Roof Slope 9 ,Job,Site I Aerodynamic Multiplier Product Approval I Restorring'Moment due to Gravity Me Product Approval I Attactrmerrt Reslstbnos M, Product Approval I Required ltAoment Resistance Me Calculated I Minimum Attachment Resistance: F' Product Approval I Required Uplift Resistap f, Ca(culathd I Average Tile We ght W Product Approval 1 Tile Dimensions L =length W width Product Approval 1 All calculations must be submftted to the building official at the time of permit application. 1 t 15,40 FLORIDA BUILDING CooE--BUILDING,ath Et'lMON(20" i ' l Copyri9k to,.or tisxansecr t%ICC(ALL RIGHTS'RESERVED):=MW by Eliew Palacio calea 8,2015 Id;UM AM p xftaV to License Agrreme�z.iYo r rnprcductians authorised. MIAMI-DADE COUNTY PRODUCT CONTROL SECTION DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES(RER) 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 ACCEPTANCE (NOA) �tww.miamidade.gov/ecaaomv Polyglass USA,Inc. 150 Lyon Drive Fernley,NV 89408 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials.The documentation submitted has been reviewed and accepted by Miami-Dade County RER-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&ction (In Miami Dade County)and/or the AHJ(in areas other than Miami Dade County)reserve the right to have00 �• product or material tested for quality assurance purposes.If this product or material fails to lirfo;r6in the acpgpied •• manner,the manufacturer will incur the expense of such testing and the AHJ may immediately'revo�Ce,moA16 or ••••" suspend the use of such product or material within their jurisdiction. RER reserves the right to•0ev a this acceptance,, ' . .Pk P if it is determined by Miami-Dade County Product Control Section that this product or materi,.al fti�s to meu t the••• requirements of the applicable building code. ••o•.• . This product is approved as described herein,and has been designed to comply with the Flori44 BWlding Com••. ••�•• including the High Velocity Hurricane Zone of the Florida Building Code. ..'..• •• ' •• DESCRIPTION:Polyglass Self-Adhered Roof System over Wood Decks • ' •••••• • LABELING:Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and followtllg 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 NOA revises NOA# 13-0514.10 and consists of pages i through 33. The submitted documentation was reviewed by Alex Tigera. M CQUN77 '400w� NOA No.: 13-1217.01 Expiration Date: 10/11/17 Approval Date:11/06/14 Page 1 of 33 ROOFING ASSEMBLY APPROVAL Category Roofing Sub-Cateaory: Modified Bitumen Materials SBS/APP/TPO Deck Type: Wood Maximum Design Pressure -112.5 psf TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: TABLE I Test Product oduct Dimensions Specification Description Elastobase 65'2"x 3'3-3/8" ASTM D 6163, SBS modified asphalt coated fiberglass reinforced Type I base sheet. XtraFlex SBS Glass 65' 8"x 3' 3-3/8" ASTM D 6163, SBS modified asphalt coated fiberglass reinforced Base Type I base sheet. Polyglass G2 Base 108'x 36" ASTM D 4601 Asphalt-coated fiberglass reinforced base Addle. Type II . *0 , .... . Polyanchor 250'x 48" ASTM D 4601 A polymer woven,high perfet" e,synthefis base Type II sheet. *06:60 . ...... Elastobase P 65' 8"x 3'3-3/8" ASTM D 6164, SBS modified asphalt coated►ooly�ster reilfor"d base Type I sheet. . ...... .. . ..... Elastoflex SA V FR 66' 8"x 3' 3-3/8" ASTM D 6163, Self-adhered,fire-rated,fibetglas3reinforce4,SIBS .... Type I modified bitumen membrane; g?4self-adhering back •. face and a smooth top surface. fees** Elastoflex SA V 66' 8"x 3'3-3/8" ASTM D 6163, Self-adhered,fire-rated,fibe;&W%s=einfor�Vd,SUS ;••••; PLUS FR Type I modified bitumen membrane with a self-adhefi4 back face and a smooth top surface. Elastoflex SA V(1.5- 66' 8"x 3'3-'/8" ASTM D 6163, Self-adhered,fiberglass reinforced,SBS modified mm) Type] bitumen membrane with a self-adhering back face and a smooth top surface. Elastoflex SA V 66' 8"x 3' 321s" ASTM D 6163, Self-adhered,fiberglass reinforced,SBS modified PLUS Type I bitumen membrane with a self-adhering back face and a smooth top surface. XtraFlex SBS Base 66' 8"x 3' 321s" ASTM D 6163, Self-adhered,fiberglass reinforced,SBS modified SA Type I bitumen membrane with a self-adhering back face and a smooth top surface. Elastoflex SA P FR 32' 10"x 3'3-3/8" ASTM D 6164, Self-adhered,fire-rated,polyester reinforced,SBS Type I modified bitumen membrane with a self-adhering back face and a granule top surface. XtraFlex SBS G SA 32' 10"x 3' 3-3/8" ASTM D 6164, Self-adhered,fire-rated, polyester reinforced,SBS Type I modified bitumen membrane with a self-adhering back face and a granule top surface. bRAMCanacouNW NOA No.: 13-1217.01 • 1 Expiration Date: 10/11/17 Approval Date:11/06/14 Page 2 of 33 Elastoflex SA P 32' 10"x33-3/8" ASTM D 6164, Self-adhered,fiberglass reinforced,SBS modified Type I bitumen membrane with a self-adhering back face and a granule top surface. Polyflex 32' 10"x3' 3-3/8" ASTM D 6222 Torch applied,polyester reinforced,APP modified bitumen membrane with a burn off polyethylene back face and a smooth or sanded top surface. XtraFlex APP S 32' 10"x 3' 3-3/8" ASTM D 6222 Torch applied,polyester reinforced,APP modified bitumen membrane with a burn off polyethylene back face and a smooth or sanded top surface. Polybond 32' 10"x 3' 3-3/8" ASTM D 6222 Torch applied,polyester reinforced,APP modified bitumen membrane with a burn off polyethylene back face and a smooth or sanded top surface. Polyflex G 32' 10"x 3' 3-3/8" ASTM D 6222 Torch applied,polyester reinforced,APP modified bitumen membrane with a burn off polyethylene back face and a granule top surface. Polyflex SA P 32' 10"x 3'33/s" ASTM D 6222, Self-adhered,polyester reinforced,APP modified Type I bitumen membrane with a self-adhering back face and a granule top surface. "00000 Polyflex SA P FR 32' 10"x 3' 3,%" ASTM D 6222, Self-adhered,fire-rated,pol3esj&rtinforcel,(*,PSP **0":* Type I modified bitumen membranawi"a self-adbgung back,••.;• face and a granule top surfam•:.. 0 0 0 0000.. XtraFlex APP G SA 32' 10"x 3'33/8" ASTM D 6222, Self-adhered,fire-rated,pol)res1er reinfor&4 ARP • Type I modified bitumen membrane U a self-adhering back .00000 00 0 0000. face and a granule top surfagea•••• 0 00 0 0 0 •••• • Polyfresko G SBS SA 32' 10"x 3'3-Ng" ASTM D 6164, Self-adhered,fiberglass reinfon;de,SBS modified Type I bitumen membrane with a self-adhtring bjj face and••-.:. a granule top surface. • . . 000000 Polyfresko G SBS SA 32' 10"x 3' 3-3/s" ASTM D 6164, Self-adhered,fire-rated,fiberglass reinforceckjbS • FR Type I modified bitumen membrane with a self-adhering back face and a granule top surface. Polyfresko G APP SA 32' 10"x 3' 3j/g" ASTM D 6222, Self-adhered,polyester reinforced,APP modified Type I bitumen membrane with a self-adhering back face and a granule top surface. Polyfresko G APP SA 32' 10"x 3' 33/8" ASTM D 6222, Self-adhered,fire-rated,polyester reinforced,APP FR Type I modified bitumen membrane with a self-adhering back face and a granule top surface PolyKool 32' 10"x 3' 3 3/8" ASTM D6222 Self-adhered,polyester reinforced,APP modified Type I bitumen membrane with a self-adhering back face and a white film laminate on the top surface. XtraFlex Kool APP S 32' 10"x 3'3-31g)' ASTM D6222 Self-adhered,polyester reinforced,APP modified SA Type I bitumen membrane with a self-adhering back face and a white film laminate on the top surface. Polyglass APP Base 65' 8"x 3' 33/8" ASTM D 6509 APP modified asphalt coated fiberglass reinforced Type I base sheet. MIAMFDAD�G UN7Y NOA No.: 13-1217.01 Expiration Date: 10/11/17 Approval Date:11/06/14 Page 3 of 33 PG325 Cold Process 1,3,5,50,55 gal.or ASTM D3019 A fibered cold process adhesive for use with roll or Adhesive tube Type III BUR roofing. PG 100 Asphalt Primer 1,3,5,50,55 gal, ASTM D41 A penetrating solution of solvent and a blend of tube or 17 oz.spray selected asphalts used to promote adhesion. can XtraFlex 10 Asphalt 1,3,5,50,55 gal, ASTM D41 A penetrating solution of solvent and a blend of Primer tube or 17 oz.spray selected asphalts used to promote adhesion. can PG350 Mod Bit 1,3,5,50,55 gal.or ASTM D3019 A fibered rubberized adhesive designed for use with Adhesive tube Type III modified bitumen membranes. PG400 Plastic Roof 1,3,5,50,55 gal.or ASTM D4586 A thick,fibered,rubberized flashing cement for use in Cement tube ASTM D3409 dry or damp conditions. PG425 Wet/Dry Roof 1,3,5,50,55 gal.or ASTM D4586 A thick,fibered,rubberized flashing cement for use in Cement tube ASTM D3409 dry or damp conditions. PG450 Flashing 1,3,5,50,55 gal.or ASTM D4586 A thick,fibered,rubberized flashing cement. Cement tube PG500 MB Flashing 1,3,5,50,55 gal.or ASTM D4586 A thick,fibered,rubberized flashing cement u use Cement tube with modified bitumen membranes•. 000000 • Polyplus 35 Premium 1,3,5,50,55 gal. or ASTM D3019 A fibered rubberized adhesive designe000d for We%*vith ' 0000. 0000.. Mod Bit Adhesive tube Type III modified bitumen membrangi 0:0• 00 • XtraFlex 35 Premium 1,3,5,50,55 gal.or ASTM D3019 A fibered rubberized adhesive lesioned for us&with Mod Bit Adhesive tube Type III modified bitumen membranes.,•• as Vt Polyplus 45 Premium 1,3,5,50,55 gal.or ASTM D4586 A thick,fibered,rubberized�esjking cement• • 0 0 0 0' Flashing Cement tube :90:0: 0 0.0 Polyplus 50 Premium 1,3,5,50,55 gal.or ASTM D4586 A thick,fibered,rubberized flashing cempV11(Ouse •••0:. MB Flashing Cement tube with modified bitumen mer4brap%. 0 • 0000.. XtraFlex 50 Premium 1,3,5,50,55 gal.or ASTM D4586 A thick,fibered,rubberized flashing cement fq,use 0 Modified Wet/Dry tube with modified bitumen membranes. Cement Polyplus 55 Premium 1,3,5,50,55 gal.or ASTM D4586 A mastic compound for use as a roof flashing Modified Flashing tube adhesive. Cement MIAMNDADE COUNTY NOA No.: 13-1217,41 Expiration Date: 10/11/17 Approval Date:11/06/14 Page 4 of 33 APPROVED INSULATIONS: TABLE 2 Product Name Product Description Manufacturer (With Current NOA) Polytherm-H Polyisocyanurate foam insulation Polyglass USA,Inc. Polytherm Polyisocyanurate foam insulation Polyglass USA,Inc. ACFoam-II Polyisocyanurate foam insulation Atlas Roofing Corp ACFoam-IIF Polyisocyanurate foam insulation Atlas Roofing Corp High Density Wood Fiberboard Wood fiber insulation board Generic DensDeck,DensDeck Prime Gypsum insulation board Georgia-Pacific Gypsum LLC H-Shield Polyisocyanurate foam insulation Hunter Panels,LLC H-Shield CG Polyisocyanurate/perlite composite insulation Hunter Panels,LLC ENRGY-3,JM ISO 3 Polyisocyanurate foam insulation Johns Manville Corp. Fesco Board Expanded mineral fiber Johns Manville Corp. Multi-Max FA-3 Polyisocyanurate foam insulation rmVgperatm-ai&. •..... SECUROCK Gypsum-Fiber Roof Board Fiber reinforced coverboard �Urjij%ci States G-Psum '. •Corporatio! •' " • • ...... .... . ..... ...... .. . ..... •• •• •• • •••••• • • • • • •••••• MWNU•R EC UN71f NOA No.: 13-1217.01 •• ► Expiration Date: 10/11/17 Approval Date: 11/06/14 Page 5 of 33 APPROVED FASTENERS: TABLE 3 Fastener Product Product Manufadurer Number Name Description Dimensions (With Current NOA) 1. Dekfast Fasteners 12, 14& Insulation fastener for wood, SFS Intec,Inc. 15 HS steel and concrete decks 2. Dekfast Galvalume Steel Galvalume hex stress plate. 2'/$'x SFS Intec,Inc. Hex Plate 3 '/4" 3. #14 Roofgrip Insulation and membrane Various OMG,Inc. fastener 4. Flat Bottom Metal Plate A2-SS aluminized steel plate 3"square OMG,Inc. 5. Trufast#14 HD Fastener Insulation fastener for steel and Altenloh,Brinck&Co. wood decks U.S.,Inc. 6. Trufast 3"Metal Insulation Round Galvalume AZ50 steel 3.23 round Altenloh,Brinck&Co. Plate plate 3"round U.S.,Inc. ."00 7. Polygrip Fasteners#12,#14 Insulation fastener for wood, Various Polyglas?V.%& *1nc •••••• .. &415 steel and concrete decks . •••• • 8. Polygrip Hex Plates Galvalume hex stress plate. 2'/8"x 3fotyglas?USA,Inc •••••• 3 1/4" 0 00 ...... .... . ..... 00 .. .. 0.. . ...... rtuurtaoaa NOA No.: 13-1217.01 s Expiration Date: 10/11/17 Approval Date:11/06/14 Page 6 of 33 APPROVED SURFACING: TABLE 4 Product Product Application Specification Manufactur Name Description Rate er PG200 Non-Fibered Roof Coating A non fibered asphaltic coating used I'/-2 gal/sq TAS 140 Polyglass to add life and rejuvenate existing USA,Inc. BUR roofing substrates. XtraFlex 20 Bituminous Roof A non fibered asphaltic coating used 1'/z-2 gal/sq TAS 140 Polyglass Coating to add life and rejuvenate existing USA,Inc. BUR roofing substrates. PG300 Fibered Roof Coating An asphalt cutback fibered roof H/2-2 gal/sq ASTM D4479 Polyglass coating. May be applied by brush or USA,Inc. spray equipment to rejuvenate aged BUR XtraFlex Bituminous Roof An asphalt cutback fibered roof i''/2-2 gal/sq ASTM D4479 Polyglass Coating Fibered coating. May be applied by brush or USA,Inc. •.•e spray equipment to rejuvenate aged . . .... ...... BUR PG600 Non-Fibered Aluminum Non-fibered aluminum roof coating. ''/a-1 gal/sq ASND 2824 ••:Folyglass••.•:• Roof Coating •'?yr I LSSA,Inc.* • PG650 Fibered Aluminum Roof Fibered aluminum roof coating. 1'/z-2 gal/sq A$S**)32824 :••PeIyglass:0 0*0 Coating 0OT.VtJII ..USA, 0,:Inc.. PG700 Elastomeric Roof Coating A premium white elastomeric acrylic ]-1'/x gal/sq ASTM-66083 •461yglass•••••- .••••. • based roof coating(water-based). A USA,Inc. • • • . . 000006 polyester fabric may be used for .0 0 0 0 • reinforcement with this Coating. • .0. � 000000 M PG800 Non-Fibered Asphalt An asphalt base,un-fibered clay 3 gal/sq in AST ;1227 Potyglass Emulsion Roof Coating emulsion two coats USA,Inc. XtraFlex 80 Emulsion Roof An asphalt base,un-fibered clay 3 gal/sq in ASTM D1227 Polyglass Coating emulsion two coats USA,Inc. PG850 Fibered Asphalt Emulsion An asphalt base,fibered clay 3 gal/sq in ASTM D1227 Polyglass Roof Coating emulsion two coats USA,Inc. Polyplus 65 Premium Fibered Fibered aluminum roof coating. 1'/a-2 gal/sq ASTM D2824 Polyglass Aluminum Roof Coating Type III USA,Inc. XtraFlex 65 Aluminum Roof Fibered aluminum roof coating. 1%-2 gal/sq ASTM D2824 Polyglass Coating Fibered Type III USA,Inc. Polyplus 60 Premium Non- Non-fibered aluminum roof coating. %-1 gal/sq ASTM D2824 Polyglass Fibered Aluminum Roof Coating Type I USA,Inc. XtraFlex 60 Aluminum Roof Non-fibered aluminum roof coating. %r1 gal/sq ASTM D2824 Polyglass Coating Type I USA,Inc. NQA No.: 13-1217.01 JAPPROVED1 1 Expiration Date: 10/11/17 Approval Date:11/06/14 Page 7 of 33 APPROVED SURFACING: TABLE 4 Product Product Application Specification Manufactur Name Description Rate er Polybrite 70 Premium Grade A premium white elastomeric acrylic 1-1'/2 gal/sq ASTM D6083 Polyglass Elastomeric Roof Coating based roof coating(water-based). A USA,Inc. polyester fabric may be used for reinforcement with this coating. XtraFlex 70 Premium Acrylic FR A premium white elastomeric acrylic 1-1'/:gal/sq ASTM D6083 Polyglass Roof Coating based roof coating(water-based). A USA,Inc. polyester fabric may be used for reinforcement with this coating. Polybrite 90 High Solids Silicone A premium grade high solids,single 1.25 gal/sq ASTM D6694 Polyglass Roof Coating component,moisture cure,fluid USA,Inc. applied silicone coating XtraFlex SRC 9600 High Solids A premium grade high solids,single 1.25 gal/sq ASTM D6694 Polyglass Silicone Roof Coating component,moisture cure,fluid USA,Inc. 0000 applied silicone coating •••• . 0000.. Polybrite 95 Silicone Roof A single component,solvent, 1.25 gal/sq ASTP*D6194 Pa4*ass Coating moisture cure silicone coating. •••;•• •O A,Inc. ease% XtraFlex.SRC 8000 Silicone Roof A single component,solvent, 1.25 gal/sq AST0lM10000§..694 Pollglass %so@: Coating moisture cure silicone coating. 000000 :Ufto Inc. 0000. Gravel To be installed in a flood coat of 400 lbs/sq •' JA% •0 Gernric •.:..' approved asphalt at 60 lbs/sq •• •• ..0.0 ••0000 0 . • Slag To be installed in a flood coat of 300 lbs/sq ;N/A000.; Grey eric •• approved asphalt at 60 lbs/sq :••••• 0 . 0000 : .0000. so MWMMOADE OUNTY NOA No.: 13-1217.01 IMPROVED Expiration Date: 10/11/17 Approval Date:11/06/14 Page 8 of 33 EVIDENCE SUBMITTED: Test Agency Test Name/Report Report No. Date Factory Mutual Research 4470 2W7A7.AM 08.04.94 Corporation 4450 2DSA9.AM 06.22.99 4470 3001334 02.15.00 4470 3000857 01.12.00 4470 3004091 01.12.00 4470 3012321 07.29.07 4450 3014751 08.27.03 4450 3019317 06.30.04 4470 3014692 08.05.03 Trinity ERD TAS 114 11752.09.99-1 02.08.00 TAS 114 02764.09.05 09.09.05 TAS 114 02762.03.05 03.30.05 TAS 117(13)-ASTM D903 020841.06.04 06.02.04 TAS 114 PI 734.07.06-RI 0347.07 TAS 114 P 173 8.02.07 02.95:07 •••••• TAS 114 P1739.01.07 Ol.:3.97 • TAS 117(B)-ASTM D6862 C8500SC.11.07* rr.30.07 ••••'• ASTM D6164/ASTM D6222 P10490.08.08 *•*... 08.13.08 :....: ASTM D6164/ASTM D6222 P10490.10.08-Rr G,,,• 0.09�(1�8 ••' ASTM D6222 P7400.03.08-R2...... IQ.Q9�08 ..�..' TAS 114(D)—ASTM DI 876 P10070.10.08 ...... tQ,09.08 .. •• ASTM D6222 P10490.10.08-2...... 10.310.08 .• FM 4470&TAS 114 P33970.03.I 1 : 03.15.11 ;. ASTM D6163/ASTM D 4601 P33960.03.11 • &.11 Y r I TAS 114&TAS 117(13) 11757.12.00-1-RI••• o 9429.13 �•��•: TAS 114&TAS 117(13) 11757.04.01-1-RI 04.30!13 ASTM D6164 P37590.07.13-1 07.02.13 ASTM D6164 P37590.03.13-3A 03.06.13 ASTM D6163 P37590.03.13-2-R1 02.05.13 ASTM D6222 P37590.09.13 09.12.13 ASTM D4601 /TAS 1 l 7 P45940.09.13 09.04.13 TAS 114&FM 4474 P41630.08.13 08.06.13 TAS 114(H) PI3760.09.09 09.10.09 ASTM D4601 /TAS 117 P45970.05.14 05.12.14 PRI Construction Materials ASTM D6222 PUSA-061-02-02 01.28.08 Technologies ASTM D6222 PUSA-062-02-02 12.04.08 ASTM D6163 PUSA-064-02-02 02.27.08 ASTM D6694 PUSA-134-02-01 05.16.14 ASTM D6694 PUSA-135-02-01 05.16.14 CM[UAkM1ffijWMMEhW NOA No.: 13-1217.0] Expiration Date: 10/11/17 Approval Date: 11/06/14 Page 9 of 33 Membrane Type: SBS/APP Deck Type 1: Wood,Non-Insulated Deck Description: 19132"or greater plywood or wood plank. System Type E(1): Base sheet is mechanically attached to roof deck. All General and System Limitations apply. Roof accessories not listed in Table 1 of this NOA are not approved and shall not be installed unless said accessories demonstrate compliance with prescriptive Florida Building Code requirements and are field fabricated utilizing the approved membranes listed in Table 1. Base Sheet: One ply of Elastobase,XtraFlex SBS Glass Base, Elastobase P or Polyanchor fastened to the deck as described below: Fastening#1: Attach base sheet using 1 i ga.annular ring shank nails and 1-5/8"diameter tin caps spaced 8" o.c. in a 4"lap and 8"o.c. in three equally spaced staggered rows in the center of the sheet. Fastening#2: Attach base sheet using OMG#14 Roofgrip fasteners and Flat Bottom Metal Plates,Dekfast #14 with Dekfast Galvalume Steel Hex Plates,Polygrip Fasteners#14 with Polygrip Hex Plates or Trufast#14 HD Fasteners with Trufast 3"Metal Insulation Plates spacedef "dc.in a 4"lap and 12"o.c.in two equally spaced staggered rows in the centet0.&&sheet. ���' 0000 e 000000 0000 0000.0 Ply Sheet: One or more plies of Elastoflex SA V(1.5-mm),Elastoflex SA V PL,jA:4tFaFlex SBS Base SA,Elastoflex SA V FR(1.5-mm)or Elastoflex SA V PLUS FR,selfvdbered. :0000: 0000.. 0000 . soVo Membrane: One ply of Polyfresko G SBS SA,Polyfresko G SBS SA FR,Poiyfrm4oG.4PP SN. . 0 0:0 0' Polyfresko G APP SA FR,Elastoflex SA P,Elastoflex SA P FR,XtMF10ABS G*SA*Folyflex...... SA P,PolyKool,XtraFlex Kool APP S SA,Polyflex SA P FR or Xt4tf.I •IkPP G SAs self- • . 0000:. adhered. 0 0....0.0 Or . . . .Osseo One ply of Polyflex G,torch-applied. e . Surfacing: (Optional)Install one of the approved surfacing products listed in Table 4 to obtain desired coating or required fire classification. Maximum Design Pressure: -52.5 psf;(See General limitation#7.). MIAMMDANOA No.: 13-1217.01 DE GUNTY ...o , Expiration Date: 10/11/17 Approval Date:11/06/14 Page 26 of 33 WOOD DECK SYSTEM LIMITATIONS: 1. A slip sheet is required with Ply 4 and Ply 6 when used as a mechanically fastened base or anchor sheet. GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance; refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs./sq.,or mechanically attached using the fastening pattern of the top layer 3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt,panel size shall be 4'x 4'maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall be applied using spot mopping with approved asphalt, 12" diameter circles,24"o.c.;or strip mopped 8" ribbons in three rows,one at each side lap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbs./sq. ."•• Note: Spot attached systems shall be limited to a maximum design pressure of 45JP1fi ""•• 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force��F,'�Ylue of�N��a�lR,as tested in compliance with Testing Application Standard TAS 105. If the fastener value„A Jjejd-tested,acre below 275 Ibf.insulation attachment shall not be acceptable. 6999 0 a �..... 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is.Based V 9 Mihimunl fastener resistance value in conjunction with the maximum design value listed within&speck system. Should ..%.* the fastener resistance be less than that required,as determined by the Building Official,40re%lsed fastener` ....,. spacing,prepared,signed and sealed by a Florida registered Professional Engineer,Reis IVO Architect•or . Registered Roof Consultant may be submitted. Said revised fastener spacing shall utilize theUvithd4KM:. 6040:0 resistance value taken from Testing Application Standards TAS 105 and calculations iii coulpliance with Roofin't�..�; Application Standard RAS 117. '• . 000 • . 7. Perimeter and corner areas shall comply with the enhanced uplift pressure requirements of these areas.*Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. Calculations prepared, signed and sealed by a Florida registered Professional Engineer, Registered Architect, or Registered Roof Consultant (When this limitation is specifically referred within this NOA,General Limitation#9 will not be applicable.) 8. All attachment and sizing of perimeter nailers,metal profile,and/or flashing termination designs shall conform to Roofing Application Standard RAS I i l and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones(i.e.field, perimeters,and corners).Neither rational analysis,nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones(i.e.perimeters,extended corners and corners).(When this limitation is specifically referred within this NOA,General Limitation#7 will not be applicable.) 10. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 61 G20-3 of the Florida Administrative Code. END OF THIS ACCEPTANCE MAM�►0C0U NOA No.: 13-1217.01 AWXXWM=••� ���� Expiration Date: 10/11/17 Approval Date:11/06/14 Page 33 of 33 POLYGLASS USA INC R14571 150 LYON DR FERNLEY,NV 89408 USA SINGLE PLY MEMBRANE SYSTEMS Class A-Fully Adhered '21-Deck:GI5/32 Incline:2 tion(Optional):--Polyisoeyanurate,perlite,wood fiber or polyisocyanuratelperlite board,any thickness. Barrier Board:— in.(min)G-P Gypsum DensDeck@,mechanically fastened with all joints staggered 6 in.from the p joints. Base Street:--"ELASTOBASE' sand),mechanically fastened or"ELASTOFLEX SA V PLUS FR","ELASTOFLEX SA V FR"or"£LA EX SA V FR BASE VENT"(selfadhered). MY Sheet(Optional):---"ELASTOFLEX SA V R","ELASTOFLEX SA V FR"or "ELASTOFLEX SA V Flt BASE VENT',(self adhered). •••• Membrane;--"POLYFLEX SA P FR"."POLYFRESKO APP SA " "ELASTOF�1;,X SAP' &",• ••••�• "POLYFRESKO SBS SA P FR", "ELASTOFLEX SA V FR HT',(self adher -MLTFLEX Kt�•• • FR","POLYFRESKO TORCH Flt","DUFLEX G FR","ELASTOFLEX S6 G FR-, •••••• MOP FR","ELASTOPLEX VG FR"or"ELASTOSHIELD TS G FR",heat fused •••••• • 22.Deck:C-15/32 Incline: 1/2 •.,..• ••••• ...... .. . ..... Insulation(Optional):---Polyisocyanurate 1.5 in.(min.)with all joints staggeredXS;iti,6i4ifte .)from tine• plywood Joints. •• ...... Base Sheet:---Tyue 02,mechanically fastened followed by"ELASTOBASE" mechatig0ved •. Ply Sheet(Optional):—"ELASTOFLEX SA V PLUS FR" "ELASTOFLEX SAV FR or r **see: "ELASTOFLEX SA V FR BASE VENT",(self adhered) • • :....: Membrane:—"POLYFLEX SA P FR","POLYFRESKO AFP SA P FR","ELASTOFLEX SA 1'Fist": • "POLYFRESKO SBS SA P FR",or"DUPLEX G FR',"POLYFLEX G FR","ELASTOFLEX S6 G �+ FR',"POLYFRESKO MOP FR',"ELASTOFLEX VG FR"or"ELASTOSHIELD TS G FR",heat fused. ®2012 UL LLC The appearance of a company's name or product in this database does not in itself assure that products so identified have been manufactured under UL's Follow-Up Service.Only those products bearing the UL Mark should be considered to be Listed and covered under UL's Follow-Up Service.AIways look for the Mark on the product, UL permits the reproduction of the material contained in the Online Certification Directory subject to the following conditions: 1.The Guide Information,Designs and/or Listings(files)must be presented in their entirety and in a non-misleading manner,without any manipulation of the data(or drawings).2. The statement'Reprinted from the Online Certifications Directory with permission from UL"must appear adjacent to the extracted material.In addition,the reprinted material must include a copyright notice in the following format:"Q 2012 UL LLC"_ R SECTION 1524 HIGH VELOCITY HURRICANE?ONES—REQUIRED OWNERS NOTIFICATION FOR RFING CONSIDERATIONS 1524.9 Scope.As it pertains to the section,it is the responsibility of roofing contractorid:provide the owner with the required roofing permit,and to explain to the owner the content of the section.The provisions of Section 84402 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 ft—owner ant the contractor,The owner's initial in the designated spam indicates that the item has been explained. 2. w" k Renailing wood decks:When replacing roofing,the existing wood roof dedt mayhaue 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). 0000 • e . 0000 ...... • • e e 4, 9�Z— Exposed Ceiling:Exposed,open beam ceilings are where ury""�,of the rggt c�eeeking e• can be viewed from below.The owner may wish to maintain the architectural •••••• appstagce therefWe, roofing nail penetration of the underside of the decking may not be acceptable.Us ppides the option of;•••• maintaining the appearance. •••••• *000* ••••• 0000•• • • 6. ��Overftw scuppers wall outlets):It Is required that.rainwater floV R$o that the Poof is '. not overloaded from a buildup of water.Perimetededge wall or other roof extension eayblo4*is:• •••••• discharge if overflow scuppers(wall outlets)are not provided. it may be necesftylo tnstall ivw lovy •••• scu rs in accordance with the requirements of Sections 84402,'R4403 and R4413. •00 r7 T)L— IIZI1� Owner/Agents S ure Bate Contractor Signature Dat® SO hI) CL • . 5t. w64weS roperty Address �C� 33t 3 $ Permit Number Revised on 719/2009 L:D,07I0112096