RF-17-2999 (2) e�
ENGINEERING
4225 SW 71 iami. FI 33155
Tel: 786-398-9179 Ave,Fax: 786-800-2627
a1 roofinsgectionO-gmail.com
LAB CERTIFICATION #16-0510.15
SITE SPECIFIC INFORMATION 4
UPLIFT TEST-TAS #106
02/02/2018
Roofing Contractor A-1 PROPERTY SERVICES Permit# RF12-17-2999
Job Address 1064 NE 97 ST MIAMI SHORES
Owner's Name UNIQUE HOMES LLC
Type of Tile FLAT 13" Date Installed
Approximate Roof Height 15' feet Roof Pitch 3/12 Type of Access to Roof LADDER
Approximate Square Footage of Roof 20 ftZ Required Testing Force 35 Lbs
Date Tested 02/02/2018 Number of Tests 45 Testing Equipment F.G.E.100
Contact Name GEO :Phone# 786-419-5041
LOCATION #OF TEST PASS #OF TEST FAIL
Corner 6 Tests 6 Pass Test Fail
Perimeter 8 Tests 8 Pass Test Fail
Field 20 Tests 20 Pass Test Fail
Ridge 11 Tests 11 Pass Test Fail
TOTAL 45 Tests 45 Pass 0 Test 0 Fail
IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106,THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST.THIS TAS 106 TEST HAS BEEN PERFORMED IN FULL ACCORDANCE TO THE
REQUIREMENTS OF DADE COUNTRY,WITH NO DEVIATIONS.THIS REPORT IS NOT GUARANTEED IN CASE OF CASE OF NATURAL DISASTERS.THIS REPORT IT IS NOT VALID FOR INSURANCE CLAIMS.
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ryJob Address 1064 NE 97 ST MIAMI SHORES 3
Permit Number RF12-17-2999
Roof Drawing
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44 132
43
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39
34
36
45
29
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' ♦S��R�s Lr Miami Shores Village
nn au.�
\� Building Department
II 10050 N.E.2nd Avenue
` L2 OV Miami Shores, Florida 33138
�l0ipA Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit# DATE:
INSPECTION AFFIDAVIT
Iv G licensed as a (n) Contractor/Engineer/Architect,
(Print name and circle cense Type) FS 468 Building Inspector
,
`License#: 02-0I20<639(,o
'On or about , I did personally inspect the roof deck nailing
(Date&time)
work at 1C)( t)L j I.'r:::" ( I?
(Complete Job Site Address)
Based upo that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Manual (Ba ed on 553.844 F.S)
b
Signature
State of Florida
County of Dade:
The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above property
mentioned.
Sworn to and subscribed before me this� day of--bCb
RAQUEL GONZALEZ
Notary Public, Sate of Florida at Large MY COMMISSION Al GC3121820
r
EXPIRES July 05,2021
'General,Building,Residential,or Roofing Contractors or any individual certified under 468 F.S.to make such an inspection.Include photographs of each plane of the roof with
permit#and address#clearly shown marked on the deck for each inspection
SNoR 03
s L� Miami shores Village
a•••_ Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
�CORiDP' Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit# Q>c is—� 7" c�- 99 / DATE:
INSPECTION AFFIDAVIT
I a S Vckn (Qru ox o, licensed as a (n) Contractor/Engineer/Architect
(Print name and circle License Type) FS 468 Building Inspector
License#: CCC 130 93al69
On or about lC� ' a I did personally inspect the roof deck nailing
(Date&time)
work at /d 04 N 9 2 ST
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit
Man I (Based on 553.844 F )
I1 I
g �ture
State of Florida
County of Dade:
The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above'property
mentioned.
Sworn to and subscribed before me this 30 day of�Q G--a
RAQUEL GONZALEZ
NotaryPublic, Sate of Florida at Large � `
9 : � : MY COMMISSION#GG121820
NO,," EXPIRES July 08,2021
'General,Building,Residential,or Roofing Contractors or any individual cerUlied under 468 F.S.to make such an inspection.Include photographs of each plane of the roof with
permit#and address#clearly shown marked on the deck for each inspection
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