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RF-18-455Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Issue Bate: 2t2212018 Permit NO. RF-2-18-455 Permit Type: Roof Work Classification: Tile Permit Status: APPROVED Expiration: 08/21/2018 Parcel Number Applicant 833 NE 96 Street Miami Shores, FL 33138- 1132060142800 Block: Lot: GLOBAL CAPITAL GROUP OF S Owner Information Address Phone Cell GLOBAL CAPITAL GROUP OF SOUTH 10585 SW 26 Street - - • • - - MIAMI FL 33165- (786)333-7309 Contractor(s) Phone Cell Phone A PLUS QUALITY ROOFING COMPAN (305)807-8804 Valuation: $ 18,000.00 Total Sq Feet: 3500 Type of Work: Re Roof Additional Info: RE -ROOF TO NEW FLAT TILE SYSTEM Classification: Residential Scanning: 3 Fees Due Bond Type - Contractors Bond CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - New Roof Scanning Fee Technology Fee Total: Amount $500.00 $10.80 $4.88 $3.25 $3.60 $325.00 $9.00 $14.40 $870.93 Pay Date Invoice # 02/22/2018 02/22/2018 02/22/2018 Bond #: 3667 Pay Type RF-2-18-66532 Credit Card Cash Cash Amt Paid Amt Due $ 500.00 $ 370.93 $ 50.00 $ 320.93 $ 320.93 $ 0.00 Available Inspections: Inspection Type: Up Lift Report Tin Cap Final Roof Tile In Progress Renailing Affidavit Review Roof Cap Sheet In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoni `g. Futhermore, I authorize the above -named contractor to do the work stated. orize• Signature: Owner / Applicant / Contractor / Agent Buil•ling "► February 22, 2018 epartment Copy Date February 22, 2018 1 1S'O \; ss c5. S . BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 RECEIVED AUG 0 9 2018 C,Q h FBC 20 1' Master Permit No. ILf '-LA ss Sub Permit No. PLUMBING ❑ MECHANICAL 0 PUBLIC WORKS JOB ADDRESS: (All r\ E C\( S-% City: Miami Shores CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS • \3g County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: -\ol-)N8w1 11 C - r) e - 'ar- \Phone#: OWNER: Name (Fee Simple Titleholder): Address: g-D., t. G. E'k(o `5 k - City: ‘1••••, ca-w S VA n se_..., State: Ci•-\ o c--. CI,_ Zip: 3 \ 3 2 Tenant/Lessee Name: Ciao"oc.C-1 u,\ �;� oc. SoGtk, 00(1. � \\C gc,,cca u. Phone#: -46 h 3?� "3•304 Email: \ c'\OS v-_CA02., \tom es•\0QOV J t_A,t4a ;'9-222 2- CONTRACTOR: Company Name: Is \` n C) cc .� Phone#: f. 521(> 3 6 t> — SO r(1 Address: 2-\ ' J t\UJ \\ S1%'- City: K. ���. State: t\ Qualifier Name: cS.0-'C�c'� Zip: Phone#: State Certification or Registration #: \ i-\c?" S — +30 O Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New Repair/Replace ❑ Demolition Description of Work: C71— C NTt Ac CTR Specify color of color thru tile: Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ U 1 (Revised02/24/2014) 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 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. Signatu OWNER or AGENT The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 8 day of fJve)L,S- , 20 t i?, , by 8// day of lucgvQ1/4 , 20 \ by T c\.,c>.c-� Glo.��cy.., who is personally known to re146 a der/ -D0wi1pi e7yho is personally known to me or who has produced .? identification and who did take an oath. NOTARY PUBUC: Sign: Print: 0C-t',Qx Seal: MYC,MISSION RFF15201 re 8 EXPIRES: November J0, 201es Bonded Um Budget OF F1•�P as me or who has produced _►`lam identification and who did take an oath. NOTARY PUBLIC: Sign •.�scc�C. C PrintTD watt ogyss1,;°8`0 CO?+•ti l 11SS101 F 156+5 Seal: ? MY EXPIRES: November 30, 2018 Bondedlhrd Bede tiotary Ser;ises as ********************************************************************************************************** 9 �l APPROVED BY ` Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk iami Shores illage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption m Y. -b- Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time etnployees 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 BELO YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this (P) day of Au eu SA , 20 kj . B} e\ot1. �� Cj•� e.` o.. who is personally known to me or has produced as identification. Notary: /�. Qetu`? , DENIA E MY COMMISS1614;# FF 156456 tt- EXPIRES: November 30, 2018 OF nda Bondedmhru 8ud9et Notary Serri:e SEAL: E&D ROOFING INC 2170 N.W. 11 ST. MIAMI, FL. 33125 786-333-7309 Date: August 3, 2018 State of Florida County of Dade Before me this day personally appeared Edward Dominguez who , being duly Sworn, deposes and says: That he or she will be the only person working on the project located at: 833 N.E. 96 St. Miami Shores, FI. 33138 Contractor Signature Sworn to (or affirmed ) and subscribed before me this August 3, 2018 By Edward Dominguez Personally Know Notary Signature ,�PpY Pu& IpRODRIGUEZ MY COMMISSION t FF 156456 EXPIRES'. November 30, 2016 Bonded Thro Budget Notary $erylces Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-310583 Permit Number: RF-2-18-455 Scheduled Inspection Date: August 21, 2018 Inspector: Naranjo, Ismael Owner: Job Address: 833 NE 96 Street Miami Shores, FL 33138- Project: <NONE> Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number (786)333-7309 Parcel Number 1132060142800 Contractor: E&D ROOFING INC Phone: (786)366-5041 Building Department Comments RE -ROOF TO NEW FLAT TILE SYSTEM. 03-20-2018 A stop work order has been issued for this property. No work is to be performed until a permit for interior renovation and structural repairs is approved. Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re -Inspection Fee No Additional Inspections can be scheduled until re -inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP-297832. cancelled by yulissa 8/20/2018 833 August 20, 2018 For Inspections please call: (305)762-4949 Page 25 of 36 Permit N. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CHANGE OF CONTRACTOR / ARCHITECT RS- I g-os_s Owner's Name (Fee Simple Title Holder): x�O,c\oC►,_%---c_ C9t.3\Phone #: Owner's Address: ek6 S \- City: (•K\o_ S\n.o c-'C.S State : c\ O c.,8 a Zip Code: Job Address (Of where work is being done): S 33 +1 Ci. O L S r City: a Zip Code: -IS k3 Miami Shores State: _Florid Contractor's Company Name: Address: 1.40k O Su,., \`q City: M \ Qualifier's Name : Wo'-‘-t (\p 'Q\I e _ State: c \ c : hone #: �O S -� `Bo: - 88 ©Y-f Zip Code:33 1 C901N7.0..\•2..7--- Lic. Number: C,O,Q A33CD3- Architect/ Engineer of Record Name: Phone #: Address: City: State: Zip Code: Describe Work hereby certify that the work has been abandoned and/or the contractor/architect is unable or willing to complete the contract. I hold the Building Official and the Miami Shores harmless of all legal involvement. Signatu er or Agent The foregoing instrument was aknowledged before me Signature Contractor or Architect The foregoing instrument was aknowledged before me this 8 day of Lugar--\ ,20 ,by t . /✓lrbaorra y -da this g day of AtuS� , 20 by ' E p'1� Who is personally known to me or who has produced who is personally known to me or who has produced (30n ket. :F..: i Notary Public: Sign: / Seal: itoc MY OOMMISSIO irk EXPIRES: November 30, 20 .18 BentleemmoodeeINvorvSerrees as indentification. as indentification. Notary Public: ataroroya16 DENIAR0 Seal: 4 : MY COMMISSION I FF 1�` EXPIRES: November 30, 2018 47 BawledTluu Budget Notary Senses CT B Construction Trades %Allying Bosco BUSINESS CERTIFICATE OF COMPETENCY 1 4BS00065 E&D ROOFING INC 0 BA, DOMINGUEZ EDWARD s cernr*a '"e r•outimons of Chapter o" Miami -Dade CDUnti 111=11111111111111111111111111111111111111111111111 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION RC29027519 ISSUED 08/24/2017 REGISTERED ROOFING CONTRACTOR DOMINGUEZ. EDWARD E8D ROOFING, INC INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA' HAS REGISTERED wrAor tn• ort i,on• of Cm 19 Avo r L ' -CIEMDL17.$4 ' whf OftwiLlt CTSB Board BUSINESS CERTIFICATE OF COMPETENCY 1 4BS00065 E&D ROOFING INC D S.A DOMINGUEZ EDWARD STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION RC29027519 ISSUED 0812412017 REGISTERED ROOFING CONTRACTOR DOMINGUEZ. EDWARD E&D ROOFING, INC (INDIVIDUAL MUST MEET ALL LOCAL LICENSING REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA) HAS REGISTERED under tit* orov• liOn• of Cn 4409 FS Eoirt^ der £VG )' 2C'S L 'MAaL'LF"2A.. Miami -Dade County - Building and neighborhood Compliance Office Page 1 of 1 Home Product Control! Contractors Building Officials Contact us Contractor Number: Contractor name: Address: City, St, Zip: Phone: Other Phone: Fax: Email: D/B/A: Contractor Status: Contractor License Information 14BS00065 E&D ROOFING INC 2170 NW 11 ST APT 41 MIAMI (786) 366-5041 EDUDOM4@MSN.COM ACTIVE FL 33125 Class Category Category Description Expiration Date B L D G 44 ROOFING 09/30/2020 CONTRACTOR INQUIRY COMPLETE BCCO Contractor Inquiry and Complaint Search I BCCO Home Page I State License Search Menu Home I About I Phone Directory I Privacy I Disclaimer © 2001 Miami -Dade County. All rights reserved http://egvsys.miamidade.gov:1608/WWWSERV/ggvt/BNZAW941.DIA?CNTR=14BS00065 8/9/2018 Local. Business Tax Receipt Miami —Dade -County, State of Florida —THIS IS NOT... 71 G94$1 BUSINESS NAMEILOCATtON Ec. D ROOFING INC 2170 NW 11 ST-APT.41.. MIAMI FL 331.25 RECEIPT NO. EXPIRES :RENEWAL' _ SEPTEMR R30, 2018 744E3204 J Must be displ2yad:at place of business Pursuant to County Code Chapter 8A — Art. rJ & 10 OWNERER SEC. TYPE OF BUSINESS E t? D ROOFING G !NC isle SPECIALTY BUILDING CONTRACTOR PAYMENT RECEIVEDSY TAR COLLECTOR '0 EDWARD DOMINGU_Z. PRESIDENT ? SSCJ065 . 545.00 07/27/2017 _ .. . ;I:tr(s} ? CREDITCARD—i i-050545 This Local 6usinasd Tax Receipt on confirms payment at the Local Business Tax. Tlto Becoip: is act s licaas:. permit. cr a certification et the huldEf s qualifications, to dE business. Halite; ransI campIy. i!R any Q3•.'9r':m?ntal ar nongovernmental regulatory ts::s and raa; iremerts which apply t: t shuskiest,. The RECEIPT NO. above muse tro displayed cn all c:r;ratcrcial .ohiciss — Miami —Dade Cada Ssc Es-27 . For (Rate Infermation, visit ti:rimmiamiriade.ca:'a; racirnctor A'k„,_.----- © CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY, 05/25/2018 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 policy()es) 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 Enterprise CONTACT NAME: Casey Blankinship Insurance Group 12320 Race Track (a/co°.No. Extl: (800) 307-9480 iFAX INC, No): Road License#: L059361 EMAIL , , ADDRESS: caseMenterpriseinsgroup.com Tampa INSURERS) AFFORDING COVERAGE NAIC 0 FL 33626 INSURER A: Lloyds of London INSURED E & D Roofing, INSURER B : Inc INSURER C : • 2170 INSURER D : NW 11 st Apt. #41 Miami INSURER E : FL 33125 INSURER F: COVERAGES CERTIFICATE NUMBER: 14611 REVISION NUMBER: THIS IS INDICATED. CERTIFICATE EXCLUSIONS IN TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ASEL JNSD SUER WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP• (MMIODIYYYYI LIMITS X COMMERCIAL GENERAL LIABILITY DCCSGL00417-01 02/07/2018 02/07/2019 OCCURRENCE S 1,000,000 I CLAIMS -MADE I X I OCCUR DAMAGEEACH GT (Ea RENTED TEoccurnce) S 50,000 MED EXP (Any one person) S 5,000' A PERSONALS ADV INJURY S 1,000,000 . GENT X AGGREGATE POLICY OTHER: LIMIT APPLIES PER: JECT LOC GENERAL AGGREGATE 5 2,000,000 PRODUCTS -COMP/OPAGG S 2,000,000 S AUTOMOBILE — LIABILITY ANY AUTO OWNED SCHEDULED UTOS MO AUTOS OWNED ONLY - COMBINED SINGLE LIMIT (Ea accident s BODILY INJURY (Per person) S BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident_ S . S UMBRELLA UAB SEXLESS LIAR _ OCCUR CLAIMS MADE EACH OCCURRENCE S AGGREGATE S WORKERS DED I I RETENTION S S COMPENSATION AND EMPLOYERS•UABIUTY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCWDED7 n (Mandatory If es, describebe under nd N / A - SPER TATUTE OTH- EL. EACH ACCIDENT S E.L. DISEASE -EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT S U DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may b. attached If more space Is required) Certificate is for Evidence of Insurance Only License# 14BS00065 Roofing Contractor CERTIl=1r_ATP unl nem 1 , Miami Shores Village 10050 N.E 2nd Ave Miami Shores, FI. 33138-0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIONDATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 26 (2016/03) The ACORD name and logo are registered marks of ACORD JIMMY PATRONIS CHIEF FINANICAL 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: 4/14/2018 EXPIRATION DATE: 4/13/2020 PERSON: DOMINGUEZ EDWARD FEIN: 383920819 BUSINESS NAME AND ADDRESS: E & D ROOFING, INC. 2170 NW 11 ST. #41 MIAMI FL SCOPE OF BUSINESS OR TRADE: Roofing - All Kinds and Drivers 33125 IMPORTANT: 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 if, at any time after the filing 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 certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 work at RE: Permit # ne (Print name and drde License Type) License #: PO ,/j3 D 7& 3 •� of M. Shores Wage 9 Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: 3 /2 -/ 3 INSPECTION AFFIDAVIT 05') 2 4 /9 z licensed as a (n) Contractor / Engineer / Architect, FS 468 Building Inspector On or about Ji4c — ?v 1 / , I did personally inspect the roof deck nailing (Date 8 time) 3 'OE 96sT_ (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) Signature State of Fbrida County of Dade: The undersigned, being the first duly swom, deposes and says that he/she is the contractor for the above property mentioned. Swom to and subscribed before me this ,! "day of Notary Public, Sate of Florida at Larg 1�tY P(�4(k DENIARODRIGUEi EZ �° •••, My COMMISSION tiff 156456 iVovernhcx 30; 2018 3ondec ;oft! P, ool Notary Service' 'General, &id'ng, ResOn5a1, or Roofirg Contractors or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the mot wGh permit # and address # dearly storm marked on the deck for each icnspeciorn oa.Kor,. nnnrsn1R14/11nnno Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FFBC�,20 ( 1 BUILDING Master Permit No. CA f " ySs PERMIT APPLICATION Sub Permit No. BUILDING ELECTRIC ROOFING REVISION ❑ EXTENSION RENEWAL PLUMBING EI MECHANICAL PUBLIC WORKS EI CHANGE OF CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: V 3 /v 6- G[ 0 5 City: Miami Shores County: Pig/41D41e Miami Dade Zip: ��.�� Folio/Parcel#: / 1-320(0 -o 7 ' �.O v Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type:PO r`-1/ Flood Zone: BFE: F ffE: OWNER: Name (Fee Simple Titleholder): 6 ! O44 ap,--/ 6Q i 0, Phone.-yz,(, _-1-,- --3Cq Addres: gq5° Cy ;�/eS5 Wate(.S / City: TOpef/ /)' State: /ei c ' Zip: 750/c/ Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: A ° lid S Address: ROT S) //gati E City: 1la?�J State: � Zip: 33 17 7 Qualifier Name: DW41n e //�yy-��( �;�-!'1. z 01 -e 7�/ - State Certification or Registration #: C `3/ 9 .3O / `'' 3 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ ,{lri 0O Square/Linear Footage of Work: 3sov Si- . Type of Work: ❑ Addition/L'�I Alteration ❑ New J -�❑ Repair/Replace * ❑ Demolition Re.- Description of Work: ` �e .- ©� r 70 kie F `G.r -i i `e S/S7& N Phone#: ?-47r7 ,"' Phone#: 7/6 5-Y -4 7/ • Specify color of color thru tile: Submittal Fee $ S° .tom Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) 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 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 wh occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will no d a reinspection fee will be charged. Signatu OWNER or AGENT Signature NTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of / ehaack f , 20 (7 by �r):630Zfe, G0.Y G q , who is personally known to ,',e fXJT z/ e Z , who is personally known to 2- y day of y' , 20 /1 , by me or who has produced as me who has roduced identification and who did take an oath. NOTARY PUBLIC: S,tsr.Gf� Print ,Gti?i2210. Seal: erfs * ``•Ts , BETS:Novent S20.1B P BuetNoatY rEoF identification and who did take an oath. NOTARY PUBLIC: Sig c Print/Ji564.C?. *bVstpiRES: uet Seal:`=sodedura raacyser a ��o as ********************************N,***■ *********************************►****************ski****************• ,✓11 APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Florida Department of State D1 Yl 1Ot`i al efillibr7.0rg psPf.)-RArrrro.Ni fz, /1/f rifti 6WIIP OJFkti!la wetnifr Department of State / Division of Corporations / Search Records / Detail By Document Number / DIVISION OF CORPORATIONS Detail by Entity Name Florida Limited Liability Company GLOBAL CAPITAL GROUP OF SOUTH FLORIDA LLC Filing Information Document Number L14000090519 FEI/EIN Number 47-1028799 Date Filed 06/05/2014 State FL Status ACTIVE Last Event LC AMENDMENT Event Date Filed 11/03/2017 Event Effective Date 10/18/2016 Principal Address 10585 SW 26 STREET MIAMI, AL 33165 Changed: 03/20/2015 Mailing Address 10585 SW 26 STREET MIAMI, AL 33165 Changed: 03/20/2015 Registered Agent Name & Address GARCIA, BARBARA 10585 SW 26 STREET MIAMI, FL 33165 Name Changed: 11/03/2017 Address Changed: 11/03/2017 Authorized Person(s) Detail Name & Address Title MGR GARCIA, BARBARA 10585 SW 26 STREET MIAMI, AL 33165 Annual Reports Report Year Filed Date 2016 10/18/2016 2017 04/29/2017 2017 06/01/2017 Document Images 11/03/2017 — LC Amendment 06/01/2017 — AMENDED ANNUAL REPORT 04/29/2017 — ANNUAL REPORT 10/18/2016 — REINSTATEMENT 03/20/2015 — ANNUAL REPORT 06/05/2014 — Florida Limited Liability View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format View image in PDF format Florida Department of State, Division of Corporations This Instrument Prepared by: Larissa Nelson for Albertelli Law 5404 Cypress Center Drive, Suite 300 Tampa, FL 33609 Our File Number: AFLI7-66700 Property Appraisers Parcel I.D. (Folio) Number: 11-3206-014-2800 CFN: 231 80072438 BOOK 30652 PAGE 2379 DATE.02/05.2018 08:04:43 AM DEED DOC 2148.80 ?fARVEy' RL � N. C:LERK OF COURT, ;M3A-OAOE cry SPECIAL WARRANTY DEED This Special Warranty Deed, made thi 'Way o �r�between Nationstar Mortgage, LLC, having its place of business at 8950 ypress aters Blvd, Coppell, TX 7501 there by called the grantor, to Global Capital Group of South Florida LLC, a Florida Limited Liability Company, whose Post Office address is: 10585 SW 26th Street, Miami, FL 33165, hereinafter called the grantee, •••• •• W I T N E S S E T H: That grantor, for and in consideration of the sum of $10.00 and other valuable consideratiol, receiQt whereof i� • • • hereby acknowledged, by these presents does grant, bargain, sell, aliens, remis, releases, conveys and confirms grantee,untoall that • certain land situate in Miami -Dade County, Florida, viz: •• • . • • • LOT 20 AND THE WEST 1/2 OF LOT 21, BLOCK 74, OF MIAMI SHORES SECTION 3, ACCORDI1& 'I1)•11HE PLAT • THEREOF RECORDED IN PLAT BOOK 10, PAGE 37 OF THE PUBLIC RECORDS OF MIAMI-DADE COUNTT,'PI.pRIDA.: • • • • •••• • •• Property address: 833 NE 96th Street, Miami Shores, FL 33138 SEE ATTACHED EXHIBITS • • •• •• •• • • • • • •• . • • • • • • • • • • • • • • TOGETHER with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. • • • • • • • TO HAVE AND TO HOLD the same in fee simple forever. • • • • • • • • •• • •• • • • GRANTORS WILL WARRANT AND the said party of the first part does hereby covenant with the said party of the second • • part that, except as above noted, that at the time of the delivery of this deed the premises were free from all encumbrances made by it • • and that it will warrant and defend the same against the lawful claims and demands of all persons claiming by, through or under it, but against none other. (wherever used herein the terms 'grantor' and 'grantee" included all the parties to this instrument, and the heirs, legal representatives and assigns of individuals, and the successors and assigns of corporation.) IN WITNESS WHEREOF, the grantor has caused these presents to be executed in the name, and its corporate seal to be hereunto affixed, by its proper officers thereunto duly authorized, the day and year first above written. Signe. ;•led ddelivered in thsen pf: f itngs signatu Print witness name Witness si Print witness name State of County of //7� 7 aclo he foregoin ins ent was acknowledged before me t t/l'n\ �L . as Mortgage, LLC , on behalf of, e company. He/she is personally known to me or who has produce Print Notary Name /� My Commission Expires: 71' "'�Q /� `� v v Notary Seal _EANNINE R HANSON NOTARY PUBLIC STATE JF COLORADO ;OTaRYiDft20164025506 •�i� _;;^:?1-;1!5.,,0•^: E 'tP:R ESO'_06-2 0-1 _.. star Mortgage, LLC Print Name: Title: — — Assistant Secretary (Corporate Seal) • • • • • • • • • • _ ay of / 00 tr • • bz c. (' of ations$ar• •. Drivers Lice??Sba4 itlentificatidn. • • • • • • • •• • • • • • • • • • • • •• •• • • • • • • •• •• • •• • • • • • • • • � • • • • •. • • • • • • • • •• • •• • • • • • • •• • Assistant Secretary's Certificate I, Karen L. Robb, the duly elected, qualified and acting Assistant Secretary of Nationstar 'Mortgage LLC, a limited liability company duly organized and existing under the_ laws of the State of Delaware (the "Company"), hereby certify that I haveaccess to the records and minutes of • • • • the proceedings of the Board of Managers of the Company,that parsuant.1 o •. . . • resolutions of the Board of Managers of the Company, each of the individutals. • • • • • •• •. • on the attached Exhibit A has been duly delegated to the position st eppotite.' • .• • his or her name with authority to execute the types of docunlents.et fgr1h • • •• •. . .• . • .. beside his or her name, effective as of the dates set forth, and that such' appointments: have not in any way been rescinded, modified or revoked. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of the Company on May 20, 2016. KarerfL. Robb, Assistant Secretary Exhibit A Below Ise list of Authorized Document Signers of Natlonstar Mortgage Lf.0 (the 'Company') pursuant to the Delegation of Document Signing Authority, who are In addition to the elected officers as specified In the corporate records of the Company. As of May 18,2016 vamp . - :: 3iuG .; _,. Adsinjonct Tile Hold - .-, Authorized to Sign -Date Anmolnted . A J. Loll Assistant Secretary Vlce President Amdavits,Settlement Agreements for negotiations of short sales or sale of REO properties, Release Documents, Assignment of Mortgage, Modifications, Certifications 03/13/13 Aaron Alla Assistant Secretary n/a Affidavits,endorsements. allonges, assignments, and any other similar (Documents) 06/28/13 Aaron Henderson Assistant Vice President n/a Loss Mitigation Affidavits, Assignments of Mortgage. Release of Mortgage. Deed In Lieu Documents, Transfer tax forms, MERS Documents 04/09/14 Aaron Jones Assistant Secretary Closing Coordinator REO Property Sales Contract (Document) HUD or Similar Form (Document), Deeds, Assignments, AMdavits, Instruments of Conveyance, Other Similar (Document) 05/12/16 Aaron Meaux Assistant Secretary n/a Foreclosure Documents. Bankruptcy Documents, Proofs of Maim, Reaffirmation Agreements, Assignments, Affidavits, Deeds, Instruments of Conveyance, any other similar (Document) • • • • • 05/08/15 • • • • ♦ • •••• Aaron Miller Assistant Secretary n/a Deeds of Trust Notes, Subordlnations, Alfdavits •• • • "1�=0/1S• • •• • Aaron Moody Assistant Secretary REO Property Sales Contract (Document). HUD-1 or similar (Dis&?nn),i)1eds, Instruments of Conveyance, any other similar (Document), Evictfgt9asynents, Assignments, Affidavits, Releases, indemnity Letters, Settlement Agreements, Officer Certification • • 4i/7`6/1S • • • • • • le • • • Adam Allgood Assistant Secretary n/a REO Property Sales Contract (Document), HUD1 or similar ForiR erocui!nilnt • • • • • 10/297gt • • • Adam Wood Assistant Secretary Vlce President Modifications. Deeds, instruments of Conveyance, any other sigitar • ' • (Document), MERS Documents • • • e8/03/11 • • • • • • •• • Adrian Dominguez Assistant Secretary n/a Assignments. Substitution of Trustees 02/04/14 Adrienne (Meyer)Trammell Assistant Secretary Limited Vice President Modifications, MERS Documents, Assignments, Lien Releases, GNMA Documents, Instruments of Conveyance, any other similar (Document) 11/03/14 .Ai Broadway Assistant Secretary n/a Loss Mitigation Affidavits 01/01/08 Al Flowers Hazard Insurance Claims Specalist n/a Insurance Proof of Loss 04/24/14 Alum Blunt Assistant Secretary n/a Affidavits, Modifications, Deeds, Instruments of Conveyance, any other slmllar (Document), MERS Documents 01/01/12 Albany Scott Document Execution Specialist Assistant Secretary Foreclosure related documents, including but not limited to: Assignments, Affidavits, Declarations, Certifications, Verifications, Warranty Deeds, Quit Claim Deeds, other Instruments of Conveyance, and, any similar or related documents. 09/29/14 Albert Nguende Document Execution Specialist AsslstantSecretary Foreclosure related documents, including but not limited to: Assignments, Affidavits, Declarations, Certifications, Verifications, Warranty Deeds, Quit Claim Deeds, other Instruments of Conveyance. and, any similar or related documents. 09/29/14 Albert Pena Assistant Secretary Limited Vice President Foreclosure Documents, Deeds, Bankruptcy Documents (Affidavits, Proofs of Claim, Reaffirmation Agreements) 09/19/13 Alex Carey Assistant Secretary Limited Vlce President Foreclosure Documents, Assignments, Affidavits, Deeds, Instruments of Conveyance and any slmllar (Document) 01/15/14 Dana Bledsoe Assistant Secretary n/a Lost Note Affidavit, HUD Lost Subordinate Note 02/20/15 Danesha Rose Assistant Secretary n/a Lien Releases, Endorsements, Altonges, Assignments, GNMA Documents 06/25/15 Daniel Berens Assistant Secretary a/a Foreclosure Documents, Bankruptcy Documents, Proofs of Cahn. Reaffirmation 02/03/14 Agreements. Assignments, Affidavits, Deeds, Instruments of Conveyance. any other similar Document Daniel Kleiner Assistant Secretary Asset Manager REO Property Sales Contract,( Document) HUD or Similar Form (Document) 10/24/13 Daniel Marks Default Resolution Manager n/a Affidavit in Lieu of Witness, Motion to move to Telephonic Appearance, Motion to Continue 04/10/14 Daniel Pesatore Assistant Secretary n/a REO Property Sales Contract (Documents), HUD or Similar Form (Document), Deeds, Assignments, Affidavits, Instruments of Conveyance, Other Similar 03/01/16 (Document), Eviction Documents Dankly Horvath Assistant Secretary n/a Foredosure Documents, Assignments, Affidavits, Deeds, instruments of 0111y55(ats Conveyance, any other similar (Documents), MERS Documents • • • • •••• • • • •• • ••• • • Dankile Armstrong Assistant Secretary REO Manager REO Property Sales Contracts (Document), HUD-1 or Similar Pgt•(gegi•n•nt), Deeds, Instruments of Conveyance, Evictions, and any other similar(( current) b1/054,tj •••••• • •••• •• • DanI He Carmouche-Jones Assistant Secretary a/a Foreclosure Documents, Bankruptcy Documents, Proofs of Ctatm4��a•tkn • 10% 641‘ • Agreements, Assignments, Affidavits, Deeds, Instruments of Conveyance, any other similar (Document) • • • • • • • • • • • • • • •• •• • •• DannilkChapman Assistant Secretary' n/a RED Property Sales Contract (Document), HUD orShallarForn•(1o•n•i.W. 05/12416 Deeds, Assignments, Affidavits, Instruments of Conveyance, Ot: r SlnAlar ile• (Document) • • • • • • • Daphne Proctor Document Execution Assistant Secretary Foreclosure related documents, Induding but not limited to: Assignments,* 0W/i9/14 Spedallst Affidavits, Declarations, Certifications, Verifications, Warranty Deeds, Quit • • • Claim Deeds, other Instruments ofConveyance, and, any similar or related documents. •• • Darin Colwell Assistant Secretary n/a Loan Modification Agreements, Affidavits, intake Sheet, Tax information, Certificate of Residence, Loan Agreement Disclosure, Form FP 7/C, MERS 01/28/16 Documents, GNMA Documents, HUD Subordinate Documents Darla Duncan Document Execution Specialist Assistant Secretary Foreclosure related documents, including but not limited to: Assignments, Affidavits, Declarations. Certifications, Verifications, Warranty Deeds, Quit 09/29/14 Claim Deeds, other Instruments of Conveyance. and, any similar or related documents. Darryl Sanders Assistant Secretary Foreclosure Specialist Foreclosure Documents, Foreclosure Deeds, Bankruptcy Documents (Affidavits, Proofs of Clain, Reaffirmation Agreements), MERS Documents 03/13/13 Daryl McLeod Assistant Secretary n/a RED Property Sales Contract ( Documents), HUD or Similar Form (Document), Deeds, Assignments, Affidavits, Instruments of Conveyance, Other Similar 03/12/14 (Document), Eviction Documents Dave Hickey Assistant Secretary n/a Foreclosure Documents,Assignments, Affidavits, Deeds, Instruments of 04/16/12 Conveyance, any other similar (Document). Eviction Documents Dave Johnson Assistant Secretary n/a Foreclosure Documents, Assignments, Affidavits, Deeds, Instruments of 12/03/13 Conveyance, any similar (Document) David Andews Document Execution Assistant Secretary Foreclosure Documents, Assignments, Affidavits, Deeds, Instruments of 06/02/1S Spedalist Conveyance, any other similar (Document) David Davis Assistant Secretary n/a Foreclosure Documents, Assignments, Affidavits, Deeds, instruments of 12/03/13 Conveyance, any similar (Document) Sworn to and subscribed before me this IVI iami Shores Vitiage Building Department 10050 N. E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE - BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FI 33138 Re: Owner's Name: 3 0 ti e Sz C- (a Q Property Address: 4.3 3 ,t> £ q'C ,s d— Roofing Permit Number: Dear Building Official: Date: �- 2 t-i/) L f K • • • • • • •• • • ••.. • • • • • • •• •• • • • • • • • • • •• • • • • • . • •• • • • • • • • • •• •• • • • •• • •• • • .\ e t E f -t2 C \ Pr— certify that I am not required to retrofit the rooCto wad connrai;Q§ of my building because: • •'• ' •• • •• • • • • • The just valuation for the structure for purpose of ad valorem taxation is Tess than $300,000.00, Please attach proof of ad valorem taxation. o The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions of 1994 editio e - - South Florida Building Code (1994 SFBC) Print Name State of Florida County of Dade The undersigned, being the first duly swom, deposes and says that he/she is the owner for the above property mentioned. 2O Notary Public, Sate of Florida at Large z ?eg • When the just valuation of the structure for purpose of ad valorem SFBC. Then you must provide a building application from a Gen Revised on 5/21/2009 day of r 2_0/y qual to •, .1. a than $300,000.00, and the building was not constructed with FBC nor a 1994 oy�foll�jl ' ,,, use + ::•I. ?. io• n Hurricane Mitigation. EXPIRES: November 30, ?.018 nnnA2� n•ri r)einnl • Property Search Application - Miami -Dade County Summary Report Property Information Folio: 11-3206-014-2800 Property Address: O � 833 NE 96 ST ores, FL 3313 - r SU r\01 . �( Owner . GLOBAL CAPITAL GROUP OF SOUTH FLORIDA LLC Mailing Address MIAMI, ---- FL 33165 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds / Baths / Half 2/2/0 Floors 1 Living Units 1 Actual Area 2,052 Sq.Ft Living Area 1,632 Sq.Ft Adjusted Area 1,839 Sq.Ft Lot Size 8,625 Sq.Ft Year Built s 1946 Assessment Information Year 2017 2016 2015 Land Value $258,854 $224,198 $207,224 Building Value $80,636 $80,636 $80,636 XF Value $1,675 $1,675 $1,466 Market Value $341,165 $306,509 $289,326 Assessed Value $341,165 $262,480 $238,619 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap Assessment Reduction 3 $44,029 $50,707 Note: Not all benefits are applicable to all Taxable Values (i e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 3 PB 10-37 LOT 20 & W1/2 LOT 21 BLK 74 LOT SIZE 75.000 X 115 OR 19910-3146 25035-3386 0901 5 COC 25346-2938 01 2007 1 Generated On : 2/16/2018 • . • • Taxable Value Information .•.• .. .•Q947 • •• 00161 •••••Q015 • County • • •• �• �• .• • •• -•••-• • $0 Exemption Value •. •V4 $0 Taxable Value $841,16; 4262,480 •6E4,619 School Board • • • •• . •• - . • Exemption Value $0 • • • . •$0 $0 Taxable Value $341,165 $306,509 $289,326 City Exemption Value $0 $0 $0 Taxable Value $341,165 $262,480 $238,619 Regional Exemption Value $0 $0 $0 Taxable Value $341,165 $262,480 $238,619 Sales Information Sale Previous price OR Pa 9e Book Qualification Description 01/05/2018 $358,100 30852-2379 Financial inst or "In Lieu of Forclosure" stated 08/03/2017 $100 30645-2541 Federal, state or local government agency 11/09/2016 $100 30302-4327 Corrective, tax or QCD, min consideration 01/01/2007 $420,000 25346-2938 Sales which are qualified 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 http://www.miamidade.gov/info/disclaimer.asp Version: -operty Search Application - Miami -Dade County Summary Report Property Information Folio: 11-3206-014-2800 Property Address: 833 NE 96 ST Miami Shores, FL 33138-2521 Owner GLOBAL CAPITAL GROUP OF SOUTH FLORIDA LLC Mailing Address 10585 SW 26 ST MIAMI, FL 33165 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY : 1 UNIT Beds / Baths / Half 2 / 2 / 0 Floors 1 Living Units 1 Actual Area 2,052 Sq.Ft Living Area 1,632 Sq.Ft Adjusted Area 1,839 Sq.Ft Lot Size 8,625 Sq.Ft Year Built 1946 Assessment Information Year 2017 2016 2015 Land Value $258,854 $224,198 $207,224 Building Value $80,636 $80,636 $80,636 XF Value $1,675 $1,675 $1,466 Market Value $341,165 $306,509 $289,326 Assessed Value $341,165 $262,480 $238,619 Benefits Information Benefit Type 2017 2016 2015 Non -Homestead Cap Assessment Reduction $44,029 $50,707 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 3 PB 10-37 LOT 20 & W1/2 LOT 21 BLK74 LOT SIZE 75.000 X 115 OR 19910-3146 25035-3386 0901 5 COC 25346-2938 01 2007 1 Page 1 of 1 Generated On : 2/22/2018 Taxable Value Information • • • • • • • • •••2017 ' '2016 • • 2015 •• County • • ' • ' •• •• • ••• Exemption Value • • • • 6A • • • • $0 ' • $0 Taxable Value $341,16t :$a6Q!1€0 • • • $238,�19 • • School Board • �' •••• • • • • • • • Exemption Value $0 • " ' $0 $0 Taxable Value $341,165 $306,509 $289,326 City Exemption Value $0 $0 $0 Taxable Value $341,165 $262,480 $238,619 Regional Exemption Value 1 $0 $01 $0 Taxable Value $341,165 $262,480: $238,619 Sales Information Previous Sale Price OR Book - Pa a 9 Qualification Description 01/05/2018 $358,100 30852-2379 Financial inst or "In Lieu of Forclosure" stated 08/03/2017 $100 30645-2541 Federal, state or local government agency 11/09/2016 $100 30302-4327 Corrective, tax or QCD; min consideration 01/01/2007 $420,000 25346-2938 Sales which are qualified 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 http://www.miamidade.gov/info/disclaimer.asp Version: http://www.miamidade.gov/propertysearch/ 2/22/2018 Florida Building Code 6th Edition High -Velocity Hurricane Zone Uniform Per N Section A (General Inform s Name Address ROOF CATEGORY O Low Slops 0 Mechanically Fastened Tile Mortar/Adhesive Asphaltic ❑ Metal Panel/Shingles 0 Wood Shingles/Shak Shingles O New Roof ❑ Prescriptive BUR-RAS 150 ROOF TYPE R).Rooflng 0 Recovering Are there Gas Vent Stacks? Yes❑ NOR Type: Natural ❑ Limn. . . ❑ Repair G Maintevfltnde ROOF SYSTEM INFORMATION .... • Low Slope Roof Area (SF)' .. • . Steep Sloped= .512.0 RoofArea (SF) Total (SFa.... . .. . • . •. . • .. ....1 . . .. . ....► • .• . • .. ..... . • . . • . . Section B (Roof Plan) . .. 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C111111111111111111 rs..�000n.0 n Es G .. ■ Crpna■rsnC..C■sEn.rninn R II .. • . • Florida Building Code 6th Edition (2017) High -Velocity Hurricane Zone Uniform Permit Application Form Section D (Steep Sloped Roof System) Roof System Manufacturer: 3 0041 /Z p-cp Notice of Acceptance Number: /' "' 07 /l. 0 S Minimum Design Wind Pressures, if Applicable (From RAS 127 or Calculations): P1 3y' / P2: "./ Y. / P3: -140De 7 Maximum Design Pressure 3/ "5 (From the NOA Specific System): Method of die attachment: Poht Fo 4 '1 "" Roof Slope: :12 • • • • . . Steep Sloped Roof System Description". •- • . Deck Type: . • P4.'woacl •;1 r' c za ype Underlayment: nsulatlon: Ridge Ventilation? N,A .. • •• . • • .• •. . •. . • •. . • • . . . • . •, • .• • . . . .. . f A- re Barrier: u 4' stener Type & Spacing: dhesive Type: Mean Roof Height: i 2- /flygS iiS 4 9ps ype Cap Sheet: /o /y AMA/VMS oof Covering: / 3M-014 VD Tel: Type & Size Drip dge: •• (P1: Florida Building Code 6th Edition (2017) High -Velocity Hurricane Zone Uniform Permit Application Form Section E (Tile Calculations) For Moment based the systems, choose either Method 1 or 2. Compared the values for Mrwilth the values from M,► If the Mr values are greater than or equal to the Mr values, for each area of the roof; then the the attachment method 1s acceptable. Method 1 "Mo ent Based Tile Calculations Per RAS 12T' L.315211.3 )—Mg:1•(ea.. 3.")(9 3, _ z 3:. NOA 1�I • � � . J� ��l � Mg: /4/2 — NOA 11ir 3/.3 (P3: z A • 3/3 gm3 l.12� - Mg: "7. (/2.. Ma_2.42. 0 NOA r .74 3 Method 2 "Simplified The Calculation Per Table Below" Required Moment of Resistance (M) From Table Below NOA Mr RoofMopssb�ps Heightl 212 3:12 4:12 5:12 8:12 7:12 Mr Required Moment Resistance• 15' 34A 20' 38.5 32.2 30A 28A 28A 24A 34A 3L2 30.1 28.0 25.9 25' 382 38.0 33.8 31.8 28.4 27.1 • . • . . . •• M. . 4x Ur alOWIIII M.A. IMAiliiiiLAM rerui Erviza 'Must be used in conjunction with a list of moment based tile systems endorsed bytpe Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared 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 tie attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 12T' (Pi : z 1: = z w: — ) — W z cos 8: = Frt: NOA F (P2: zl: =z w: )-W: zcos 8: = ' (P3: z1: _ = F z w:_—�)—W' zcos0: re NOA F' ri: NOA F' • . .. . . . . ..• . Where to Obtain Information Description Symbol Where to find Design Pregame P1 orP2 orP3 RAS 127 Table 1 or by an engineering =idylls prepared by PB based on ASCE 7 Mean Roof Height H Job Site Roof Slope a Job Site Restoring NOA g Moment doe to Ora* M NOA Attachment Rance Mr , NOA Required Moment Ragtime Minimum M, CalcvMed Attachment Resistance F' NOA Required Uplift Resistance F. Calculated AvemjcgeTileO W NOA e All 1= length NOA calculation must be submitted to the Building Official at the time ofpeimit application. • • • . . •• • . • DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Boral Roofing, LLC 7575 Irvine Center Drive, Suite 100 Irvine, CA 92618 MIAMI-DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175-2474 T (786) 315-2590 F (786) 315-2599 www. m iamid ad e.Eov/economy 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 Section (in Miami -Dade County) and/or the AHJ (in areas other than Miami -Dade County) reserve the right to hhygthl5 product or material tested for quality assurance purposes. If this product or material fails tolxfor=n in dig accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediatelnavoke, rxoai4fy, or suspend the use of such product or material within their jurisdiction. RER reserves the right teteeoke this dtceptancr if it is determined by Miami -Dade County Product Control Section that this product or mat4r111'Pal'Is to Vet Me• requirements of the applicable building code. "" ' This product is approved as described herein, and has been designed to comply with the FIatailding ectcte• including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Saxony 900 Concrete 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 NOA renews NOA No.13-0723.05 and consists of pages 1 through 8. The submitted documentation was reviewed by Alex Tigera. MIAMI•DADE COUNTY APPROVED NOA No.: 16-0711.05 Expiration Date: 04/26/22 Approval Date: 09/29/16 Page 1 of 8 • ROOFING ASSEMBLY APPROVAL Category: Sub -Category: Material: Deck Type: Roofing Roofing Tiles Concrete Wood 1. SCOPE This NOA approves a system using Saxony 900 (Slate, Shake & Split Shake) Concrete Roof Tile, as manufactured Boral Roofing LLC in Lake Wales, FL and described this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code, do not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in the installation section herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Applicant Saxony 900-Slate Saxony 900 Split Shake Saxony 900-Shake Trim Pieces M1AMI.DADE COUNTY APPROVED Dimensions Length = 17" Width = 13" thickness = 1-5/32" Length = 17" Width = 13" thickness = 1-9/32" Length = 17" Width = 13" thickness = 1-9/32" Length: varies Width: varies varying thickness Test Product Specifications Description '.•..' TAS 112 Flat profile, interlocking, high reisure eMsudad concrete roof tile with two rljLDQles. For d.rect deck, batten, mortar set or adhesiveisat•.applicaljpns. • TAS 112 Flat profile, interlocking, hien-pressure &traded • • concrete roof tile with two naif Boles. For direct decR' • • • , batten, mortar set or adhesive itrt.applicatioi s Top surface produced with 4 dif#ereht tonfiguratiQns: 1. Complete tile brushed •• • 2. Right half brushed (5•lfo•wri in drkwirgl • . 3. Left half brushed 4. No brush TAS 112 Flat profile, interlocking, high-pressure extruded concrete roof tile with two nail holes. For direct deck, batten, mortar set or adhesive set applications. TAS-112 Accessory trim, boosted Barcelona, concrete roof pieces for use at hips, ridges and rakes. • • • • •• • . • •. . • . NOA No.: 16-0711.05 Expiration Date: 04/26/22 Approval Date: 09/29/16 Page 2 of 8 2.1 MANUFACTURING LOCATION 2.1.1 Lake Wales, FL 2.2 EVIDENCE SUBMITTED: Test Agency Test Identifier The Center for Applied 94-084 Engineering, Inc. The Center for Applied 94-060A Engineering, Inc. The Center for Applied 25-7183-6 Engineering, Inc. The Center for Applied 25-7183-5 Engineering, Inc. The Center for Applied 25-7214-1 Engineering, Inc. The Center for Applied 25-7214-5 Engineering, Inc. The Center for Applied Project No. 307025 Engineering, Inc. Test #MDC-77 Redland Technologies 7161-03 Appendix II & III Redland Technologies Letter Dated Aug. 1, 1994 Redland Technologies P0631-01 Redland Technologies P0402 Atlanta Testing & Engineering, Inc. Celotex Corporation Testing Service Celotex Corporation Testing Service Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. American Test Lab of South Florida MIAMI.DADE COUNTY APPROVED R1.894/R2.894/R3.894 520109-1 520111-4 520191-1 Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Calculations Evaluation Calculations RT0617.04-16 Test Name/Report Static Uplift Testing TAS 101 (Mortar Set) Static Uplift Testing TAS 101 (Adhesive Set) Static Uplift Testing TAS 102 (2 Quik-Drive Screws, Direct Deck) Static Uplift Testing TAS 102 (2 Quik-Drive Screws, Battens) Static Uplift Testing TAS 102 (1 Quik-Drive Screw, Direct Deck) Static Uplift Testing TAS 102: (1 Quik-Drive Screw, Battens) Wind Driven Rain TAS 100 Wind Tunnel Testing TAS 108 (Nail -On) Wind Tunnel Testing TAS 108 (Nail -On) Wind Tunnel Testing TAS 108 (Mortar Set) Withdrawal Resistance Testing of screw vs. smooth shank nails • • • • .... . . .... . . .. .. Physical Properties TAS 112 Static Uplift Testing TAS 101 Static Uplift Testing TAS 101 . . . . . . . . .. . 25-7094 25-7496 25-7584/25-7804b-8/25-7804-4 & 5 25-7848-6 25-7183 Aerodynamic Multipliers Two Patty Adhesive Set System Restoring Moments Due to Gravity TAS 112 Date May 1994 March, 1994 Feb. 1995 Feb. 1995 March, 1995 •.... Malcir, 495 .. . • • • dct.1994 . • .. . • • • Iiec '11991 .. . • . . • Aug.,1994 .1ui▪ y.114 . Sep• t 1993 Aug. 1994 Dec. 1998 March 1999 February 1996 April 1996 December 1996 March 1995 09/01/16 April 1999 09/01/16 06/29/16 • • NOA No.: 16-0711.05 Expiration Date: 04/26/22 Approval Date: 09/29/16 Page 3 of 8 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 shall be performed in accordance with TAS 106. 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 underlayments 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 the applicable Building Code. 4. INSTALLATION .... • • 4.1 Saxony 900 (Slate, Shake & Split Shake) Concrete Roof Tile and its components:shai►be instatlt$in strict compliance with Roofing Application Standard RAS 118, RAS 119, and RAS 12Q. 4.2 Data For Attachment Calculations • • .... • •• • •Table 1: Average Weight (W) and Dimensions (I x w) • • • Tile Profile Weight-W Ib 9 ( � Length -I (ft)..'..•Wid 9 •• ft 1ft-dlll) .. Saxony 900 Slate, Shake & Split Shake 10.9 1.417 . • • . . 1.08' .. - . . . .. . .• • •.• • • ••• ••.. .• •.• • Table 2: Aerodynamic Multipliers - X (ft3) •• Tile X (ft3) X (ft3) Profile Batten Application Direct Deck Application Saxony 900 Slate, Shake & Split Shake 0.291 0.315 Table 3: Restoring Moments due to Gravity - Mg (ft-Ibf) Tile Profile 2":12" 3":12" 4":12" 5":12" 6":12" 7":12" or greater Saxony 900 Slate, Shake & Split Shake Direct Deck Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck 7.70 7.62 6.61 7.50 6.48 7.34 6.31 7.16 6.13 6.95 MIAMI•DADE COUNTY APPROVED NOA No.: 16-0711.05 Expiration Date: 04/26/22 Approval Date: 09/29/16 Page 4 of 8 • Table 4: Attachment Resistance Expressed as a Moment - Mf (ft-Ibf) for Mechanically Fastened Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19/32" plywood) Battens Saxony 900 Slate, Shake & Split Shake 2-10d Ring Shank Nails 30.9 38.1 17.2 1-10d Smooth or Screw Shank Nail 7.3 9.8 4.9 2-10d Smooth or Screw Shank Nails 14.0 18.8 7.4 1 .#8 Screw 30.8 30.8 18.2 2 .#8 Screws 51.7 51.7 24.4 1-10d Smooth or Screw Shank Nail (Field Clip) 24.3 24.3 24.2 1-10d Smooth or Screw Shank Nail (Eave Clip) 19.0 19.0 22.1 2-10d Smooth or Screw Shank Nails (Field Clip) 35.5 35.5 34.8 2-10d Smooth or Screw Shank Nails (Eave Clip) 31.9 31.9 _• •_• ...32.2 • • •.•• •• .. • .. • Table 5: Attachment Resistance Expressed as a Moment Mf (ft'f) • H for Two Paddy Adhesive Set Systems • •. •••• MA - Tile Profile Tile Application • Minimum Attativfient ,. • • • • Resistance. .. _••• • • •• • Saxony 900 Slate, Shake & Split Shake Adhesive' • • 31.311 s -. • •' • • • 1 See foam adhesive manufacturer's component approval for installation requirements. • 2 The Dow Chemical Company TileBone one -component foam minimum weight per paddy 13.9 gams.' : .. . • •' • 3. ICP Adhesives Polyset® AH-160 two -component foam, minimum weight per paddy 8 grams. •. •• •. • Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-Ibf) for Single Paddy Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Saxony 900 Slate, Shake & Split Shake ICP Adhesives Polyset® AH-160 Two -component foam 118.94 40.45 3 Large paddy placement of 45 grams of Polyset® AH-160. 4 Medium paddy placement of 24 grams of Polyset® AH-160. Table 7: Attachment Resistance Expressed as a Moment - Mf(ft-Ibf) for Mortar Set Systems Tile Profile Tile Application Minimum Attachment Resistance Saxony 900 Slate, Shake & Split Shake Mortar Sets 43.96 5 Tile-Tite Roof Tile Mortar MIAMI•DADE COUNTY APPROVED NOA No.: 16-0711.05 Expiration Date: 04/26/22 Approval Date: 09/29/16 Page 5 of 8 ... • • • • ... • .. • •. .. •• ... ... 5. LABELING 5.1 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo as detailed below, or following statement: "Miami -Dade County Product Control Approved". LABEL FOR BORAL SAXONY 900 TILES (LAKE WALES FL PLANT) LOCATED UNDERNEATH TILE 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 bui18?Ii�Mbde inbrelerto properly evaluate the installation of this system. • •... .. . • . . . . .... .• .. NAIL HOLES 17" MIAMI•DADE COUNTY APPROVED PROFILE DRAWINGS UNDERLOCK SAXONY 900 - SLATE 13" . . .. .. • • • • • • • • • • • • • •• • .. • • • . . • .. . • .• • . • • . • • . .. . • . • .. 1-5/32" (Slate) COVERLOCK NOA No.: 16-0711.05 Expiration Date: 04/26/22 Approval Date: 09/29/16 Page 6 of 8 NAIL HOLES 17" PROFILE DRAWINGS Note: Available Top Surface Finishes 5. Complete tile brushed. 6. Right half brushed (shown in drawing) 7. Left half brushed 8. No brush SAXONY 900 - SPLIT SHAKE MIAMI•DADE COUNTY APPROVED 1-9/32" (Shake) •• • • • • .• • • • •• • • • • • . • • •• • • •• •• • • • • • • • • • . •• • •• • • • • • • .• • • .• • • • • . • • • • • • • • NOA No.: 16-0711.05 Expiration Date: 04/26/22 Approval Date: 09/29/16 Page 7 of 8 NAIL HOLES 17" MIAMIODADE COUNTY APPROVED PROFILE DRAWINGS SAXONY 900- SHAKE END OF THIS ACCEPTANCE . . 13" • • • • • • • • • •• • • •• • • • • • •• •• . • • • • • •• • • • • . • • • • • • • • •• • • • • .• •• • NOA No.: 16-0711.05 Expiration Date: 04/26/22 Approval Date: 09/29/16 Page 8 of 8 .. .• • • •. • DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Polyglass USA Inc. 1111 W. Newport Center Drive Deerfield Beach, FL 33442 MIAMI-DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175-2474 T (786) 315-2590 F (786) 315-2599 www. miamidade.gov/economy 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 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 ac ieplid manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modi'fy,Qt • suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material'Mt•to meet, tlia •' requirements of the applicable building code. • This product is approved as described herein, and has been designed to comply with the Florida u:rding Cade •. including the High Velocity Hurricane Zone of the Florida Building Code. ' DESCRIPTION: Polyglass Polystick Underlayments •• • •• • • • • • ••• LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city,8V 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 NOA renews and revises NOA No.15-0410.04 and consists of pages 1 through 8. R The submitted documentation was reviewed by Freddy Semino., MIAMI•DADE COUNTY APPROVED NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 1 of 8 • ROOFING COMPONENT APPROVAL Category: Sub -Category: Material: Roofing Underlayment SBS , APP Self -Adhering Modified Bitumen PRODUCTS DESCRIPTION: Product Polystick IR-Xe Manufacturing Location #1 & #2 Polystick Dual Pro Manufacturing Location #2 Polystick Tile Pro Manufacturing Location #2 Polystick TU Max Manufacturing Location #1 & #2 Polystick TU P Manufacturing Location #2 Polystick TU Plus (Surface Printing) Manufacturing Location #1 & #2 Polystick MTS Manufacturing Location #2 Polystick MTS Plus Manufacturing Location #2 Elastoflex S6 G Manufacturing Location #2 MIAMIDADE COUNTY APPROVED Dimensions 65' x 3'33/8" Or65'x3' 60 mils thick 61' x 3'33/8" 60 mils thick 61' x 3'33/8" 60 mils thick 65'8" x 3'3-3/8" 60 mils thick 32'10" x 3'33/8" 130 mils thick 65' x 3'33/8" 80 mils thick 65'8" x 3'33/8" 60 mils thick 65'8" x 3'33/8" 60 mils thick 32'10" x 3'3-%" Test Specification ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 TAS 103 TAS 103 and ASTM D 6164 Product Description A fine granular/sand top surface self -adhering, APP polymer modified, fiberglass reinforced, bituminous sheet material for use as an underlayment in sloped roof assemblies. Designed as an ice & rain shield. A rubberized asphalt self -adhering, glass-fiber/polyester reinforced waterproofing membrane. Designed as a metal roofing and roof tile underlayment. A rubberized asphalt self -adhering, glass-fiberlpolyester reinforced waterproofing membrane. Designed as a mek l• • • • roofing and roof tile underlayment. • •• • •• • •• • , • •• A rubberized asphalt self-adhesiiug,polyester reinforced waterproofing membrane. Design d• as a aroof•t4le • • underlayment. •••• • •• ••'•• .. • • A rubberized asphalt waterproof ng membYano,•ggass fiber/polyester reinforced, witirn gt$nular suri'ace designed for use as a tile roofUndertaymedt• • • : • • • • • • A rubberized asphalt self -adhering, glass-fiberAlyester reinforced waterproofing membrane. Designed as a metal roofing and roof tile underlayment. A homogeneous, rubberized asphalt waterproofing membrane, glass fiber reinforced with polyolefinic film on the upper surface for use as an underlayment for metal roofing, roof tile, slate tiles and shingle underlayment. A homogeneous, rubberized asphalt waterproofing membrane, glass fiber reinforced with polyolefinic film on the upper surface for use as an underlayment for metal roofing, roof tile, slate tiles and shingle underlayment. Polyester reinforced, SBS modified bitumen membrane with a sanded back face and a granule top surface. For use in roof tile underlayment systems. NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 2 of 8 • MANUFACTURING PLANTS: 1. Hazelton, PA 2. Winter Haven, FL • Test A2encv Trinity I ERD PRI Asphalt Technologies Momentum Technologies, Inc. EVIDENCE SUBMITTED Test Identifier P 10870.09.08-R1 P10870.04.09 P33360.06.10 P33370.03.11 P33370.04.11 P36900.09.11 P37300.10.11 P40390.08.12-2 P37590.07.13-1 P45270.05.14 P46520.10.14 P44360.10.14 P43290.10.14 PLYG-SC 10130.06.16-3 PLYG-10130.06.16-1 PUSA-035-02-01 PUSA-055-02-02 PUSA-089-02-01 JX20H7A RX 14E8A DX23D8B DX23D8A Test Name/Report TAS 103 TAS 103/ASTM D4798 & G155 ASTM D1970 TAS 103 ASTM D 1623 TAS 103/ASTM D4798 & G155 TAS 110/ASTM D4798 & D1970 ASTM D 1623 ASTM D6164 TAS 103, TAS 110 & ASTM D 1623 ASTM D1623 TAS 103 & TAS 110 ASTM D 1970 & TAS.110 • • TAS 103 & TAS 110• • • ASTM D 1970 & TAS 11UC' • TAS 103 • TAS 103 .... . .... TAS 103/ASTM D4798 & WS; TAS 103/ASTM D4798 $ Gt51 TAS 103/ASTM D4798 & G 1 S5 TAS 103/ASTM D4798 81C415; TAS 103/ASTM D4798 & G155 Date 12/04/08 04/13/09 07/01/10 03/02/11 04/26/11 09/01 / 11 10/19/11 08/07/12 07/02/13 05/12/14 10/03/14 . 90, 07/ 14 ••40 7/14 • p6,27/16 0b"727/16 • •• • • Q9!`29/06 • • 12710/07 • • :' 07796/09 • . 04(01/08 : " 1/7019/09 • •• 02,'18/10 • • D2/18/10 • • LABELING: 1. All membranes or packaging shall bear the imprint or identifiable marking of the manufacturer's name or logo, city and state of manufacturing facility and the following statement: "Miami -Dade County Product Control Approved" or the Miami -Dade County Product Control Seal "as shown below. MIAMI•DADE COUNTY APPROVED BUILDING PERMIT REQUIREMENTS: Application for building permit shall be accompanied by copies of the following: 1. This Notice of Acceptance. 2. Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this materials. MIAMI•DADE COUNTY APPROVED NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 3 of 8 • • INSTALLATION PROCEDURES: Deck Type 1: Deck Description: System Type E(1): Anchor/Base Sheet: Fastening: Membrane: Surfacing: Deck Type 1: Deck Description: System Type E(2): Anchor/Base Sheet: Fastening: Membrane: Surfacing: Deck Type 1: Deck Description: System Type E(3): Anchor/Base Sheet: Fastening: Ply Sheet: Membrane: Surfacing: MIAMI-DADE COUNTY APPROVED Wood, non -insulated Min. 19/32" plywood or wood plank Anchor sheet mechanically fastened to deck, membrane adhered One or more plies of ASTM D 226 Type II or ASTM D 2626. Per FBC 1518.2 & 1518.4 Nails and tin caps 12" grid, 6" o.c. at a minimum 4".head lap. (for base sheet only) Polystick IR-Xe, Polystick Dual Pro, Polystick Tile Pro, Polystick TU Max, Polystick TU P, Polystick TU Plus, Polystick MTS or Polystick MTS Plus, self -adhered. See General Limitations Below. Wood, non -insulated Min. 19/32" plywood or wood plank Anchor sheet mechanically fastened to deck, membrane adhered One or more plies of ASTM D 226 Type II or ASTM D 2626. .... • • Per FBC 1518.2 & 1518.4 Nails and tin caps 12" grid, 6" o.c. at a cgitiin:um 4';jjci lap. (for base sheet only) • • • • .. Elastoflex S6 G, hot asphalt applied See General Limitations Below. • .... • .... .. .. Wood, non -insulated • • • • Min. 19/32" plywood or wood plank • Base sheet mechanically fastened to deck, subsequent cap meti,brane self• adhered. • . • • • •• • . • • .• • .• • • .. • • • • • • • •• One or more plies of ASTM D 226 Type II or ASTM D 2626. Per FBC 1518.2 & 1518.4 Nails and tin caps 12" grid, 6" o.c. at a minimum 4"head lap. (for base sheet only) Polystick MTS Plus, self -adhered with minimum 3" horizontal laps and minimum 6" vertical laps. Polystick TU Plus, self -adhered. See General Limitations Below. .. . NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 4 of 8 • INSTALLATION REQUIREMENTS: 1. 2. 3. 4. 5. 6. 7. 8. All nails in the deck shall be carefully checked for protruding heads. Re -fasten any loose deck panels, and sweep the deck thoroughly to re move any dust and debris prior to application. Place the underlayment over metal drip edge in accordance with RAS 111. Place the first course of membrane parallel to the eave, rolling the membrane to obtain maximum contact. Remove the release film as the membrane is applied. All side laps shall be a minimum of 3" and end laps shall be a minimum of 6". Roll the membrane into place after removing the release strip. Vertical strapping of the roof with Polystick is acceptable. Membrane shall be back nailed in accordance with applicable building code. When applying the membrane in the valley, start at the low point and work to the high point, rolling the membrane from the center outward in both directions. For ridge applications, center the membrane and roll from the center outward in both directions. Roll or broom the entire membrane surface so as to have full contact with the surface, giving special attention to lap areas. Flash vent pipes, stacks, chimneys and penetrations in compliance with Roof Assembly current Product Control Notice of Acceptance. All protrusions or drains shall be initially taped with a 6" piece of underlayment. The flashing tape shall be pressed in place and formed around the protrusion to ensure a tight fit. A second layer of Polystick Shall be applied over the underlayment. .... . . . .. . .. . • . . GENERAL LIMITATIONS: • 1. 2. Fire classification is not part of this acceptance. . .... ..• . . •• Polystick Dual Pro, Polystick Tile Pro, Polystick TU Plus, Polystick MTS and Poj• y�ticl1 MTS P1u§ may bg•; • • • used in asphaltic shingles, wood shakes and shingles, non-structural metal roofing, ropf tiln SystenLs and tluarry slate roof assemblies. Polystick TU P may be used in all the previous assemblies listed except metal roofing. • Polystick IR-Xe may be used in all the previous assemblies listed except metal roofirrg and ioof the systems • Polystick TU Max may be used in non-structural metal roofing and roof tile systems. • • • •.• Elastoflex S6 G may be used in roof tile systems only. • • . • . .• . . . 3. Deck requirements shall be in compliance with applicable building code. 4. Polystick IR-Xe, Polystick Dual Pro, Polystick Tile Pro, Polystick TU Max, Polystick TU P, Polystick TU Plus, Polystick MTS and Polystick MTS Plus shall be applied to a smooth, clean and dry surface. The deck shall be free of irregularities. 5. Polystick IR-Xe, Polystick Dual Pro, Polystick Tile Pro, Polystick TU Max, Polystick TU P, Polystick TU Plus, Polystick MTS and Polystick MTS Plus shall not be adhered directly over a pre-existing roof membrane as a recover system. 6. Polystick IR-Xe, Polystick Dual Pro, Polystick Tile Pro, Polystick TU Max, Polystick TU P, Polystick TU Plus, Polystick MTS and Polystick MTS Plus shall not be left exposed as a temporary roof for longer than the amount of days listed in the table below after application. Polyglass reserves the right to revise or alter product exposure times; not to exceed the preceeding maximum time limitations. Exposure Limitations (Days) MTS IR-Xe Elastoflex S6 G TU Plus TU P Tile Pro Dual Pro TU Max MTS Plus Winter Haven, FL 180 90 180 180 180 180 180 180 180 Hazelton, PA N/A 90 N/A 180 N/A N/A N/A 180 N/A 7. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 5 of 8 MIAMI•DADE COUNTY APPROVED Rule 61G20-3 of the Florida Administrative Code. 8. In roof tile application, data for the attachment resistance of roof tiles shall be as set forth in the roof tile manufacturer's Notice of Acceptance. Polystick Tile Pro, Polystick TU Max, Polystick TU Plus or Elastoflex S6 G may be used in both adhesive set and mechanically fastened roof tile applications. Polystick Dual Pro is limited to mechanically fastened roof tile applications. Polystick MTS and Polystick MTS Plus are limited to mechanically fastened with the limitations outlined in Section 9. Polystick TU P may be used in mechanically fastened roof tile applications with the exception of mortar set tile applications. 9. When loading roof tiles on roof tile underlayment for (direct -to -deck) tile assemblies, the maximum roof slope, shall be as follows: (See Table Below) Tile Profile Polystick MTS Elastoflex S6 G Polystick TU Plus, TU P, Tile Pro, Dual Pro Polystick TU Max Polystick MTS Plus System (E3) MTS Plus with TU Plus Flat Tile Prohibited without battens 4:12 6:12 6:12 5:12 6:12 Profiled Tile' Prohibited without battens 4:12 6:12 6:12 4:12 .6.1.2 • • • • • • •• •.•• • •• • •• • • The above slope limitations can be exceeded only by using battens in accordance witli.t riapprovdd Til !Systegl..:. Notice of Acceptance and applicable Florida Building Code requirements. When batterai requiredpthey shall • be utilized during loading and installation of tiles. • • • • •• •• • • • • • • • • 10. Care should be taken during the loading procedure to keep foot traffic to a minimum icd jq void ci>:opiing of • • tile directly on the underlayment. Refer to Polyglass' Tile loading detail below for loa flg,ptoceddre -stl'o tiles laid perpendicular to slope followed by a maximum four tile stack parallel to the slopo,•forototal of 64iles — for all underlayments except Polystick MTS which shall be loaded onto battens. • POL`iST1CK'TU Plus MANMADE COUNTY APPROVED (6 Max. Per Stack) 12 • •. • • • • • . • • •• . .• • • • • . • •. • NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 6 of 8 11. Refer to prepared roofing system Product Control Notice of Acceptance for listed approval of this product with specific prepared roofing products. Polystick IR-Xe, Polystick Dual Pro, Polystick Tile Pro, Polystick TU Max, Polystick TU P, Polystick TU Plus, Polystick MTS, Polystick MTS Plus or Elastoflex S6 G may be used with any approved roof covering Notice of Acceptance listing Polystick IR-Xe, Polystick Dual Pro, Polystick Tile Pro, Polystick TU Max, Polystick TU P, Polystick TU Plus, Polystick MTS, Polystick MTS Plus or Elastoflex S6 G as a component part of an assembly in the Notice of Acceptance. If Polystick IR-Xe, Polystick Dual Pro, Polystick Tile Pro, Polystick TU Max, Polystick TU P, Polystick TU Plus, Polystick MTS, Polystick MTS Plus or Elastoflex S6 G are not listed, a request may be made to the Authority Having Jurisdiction (AHJ) or the Miami -Dade County Product Control Section for approval provided that appropriate documentation is provided to detail compatibility of the products, wind uplift resistance, and fire testing results. POLYGLASS GENERAL APPLICATION GUIDELINES FOR POLYSTICK MEMBRANES PLEASE CHECK WITH LOCAL BUILDING CODES REGARDING LIMITATIONS OF SPECIFIC APPLICATIONS. LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND RECOMMENDATIONS. 1. Polyglass does accept the direct application of Polystick underlayment membranes to wood decks.. ids''tMJers are cautioned to refer to applicable local building codes prior to direct deck installation to ensure this is acceptable. Please also refer to applicable Product Data Sheets of the corresponding products. • •• •• •• 2. All rolls, with the exception of Polystick TU Plus should be back -nailed in selvage ed4•atn as per Polyglass• Back Nailing 'Guide. Nails shall be, 11 gauge ring shank type, applied with a minimuai2 ¶' meta:CUM! as • required in Miami -Dade County or simplex type nail as otherwise allowable in other regions, at a minimum rate • • of 12" o.c. Polystick TU Plus should be back nailed in designated area marked "nail wt. p.fea pa¢ el,gyilr" on .•• the face of membrane, with the above stated nails and/or disks. The head lap membrane a% is cover the,area being back -nailed. (Please refer to applicable local building codes prior to installation.) • • . • • . • • • • 3. All seal lap seams (selvage laps) must be rolled with a hand roller to ensure full contact.. • • • • •• • 4. All fabric over fabric; and granule over granule end laps, shall have a 6" wide, uniform layer of Polyglass Polyplus 55 Premium Modified Flashing Cement, Polyglass Polyplus 50 Premium MB Flashing Cement, XtraFlex 50 Premium Modified Wet/Dry Cement, Polyglass PG500 MB Flashing Cement, applied in between the application of the lap. The use of mastic between the laps does not apply to Polystick MTS. 5. A maximum of 6 tiles per stack are allowed when loading tile on the underlayments. Refer to the Polyglass Tile Loading Guidelines. See General Limitations #9 and #10. 6. Battens and/or Counter -battens, as required by the tile manufacturers NOA, must be used on all projects for pitch/slopes of 7"/12" or greater. It is suggested that on pitch/slopes in excess of 6 '/ "/12", precautions should be taken, such as the use of battens to prevent tile sliding during the loading process. 7. Minimum cure time after membrane installation & before loading of roofing tiles is Forty -Eight (48) Hours. 8. Polystick membranes may not be used in any exposed application such as crickets, exposed valleys, or exposed roof to wall details. 9. Repair of Polystick membranes is to be accomplished by applying Polyglass Polyplus 55 Premium Modified Flashing Cement, Polyglass Polyplus 50 Premium MB Flashing Cement, XtraFlex 50 Premium Modified Wet/Dry Cement, Polyglass PG500 MB Flashing Cement to the area in need of repair, followed by a patch of the Polystick material of like kind should be set and hand rolled in place over the area needing such repair. Patching membrane shall be a minimum of 6 inches in either direction. The repair should be installed in such a way so that water will run parallel to or over the top of all laps of the patch. MIAMI.DADE COUNTY APPROVED NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 7 of 8 10. All self -adhered membranes must be rolled to ensure full contact with approved substrates. Polyglass requires a minimum of 40 lbs for a weighted roller for the rolling of the field membrane. Hand rollers are acceptable for rolling of patches or small areas of the roof. Brooming may be used where slope prohibits rolling. 11. All approved substrates should be dry, clean and properly prepared, before any application of Polystick membranes commences. An approved substrate technical bulletin can be furnished upon request. It is recommended to refer to applicable building codes prior to installation to verify acceptable substrates. 12. The Polyglass Miami -Dade Notice of Acceptance (NOA) approval for Polystick membranes can be furnished upon request by our Technical Services Department by calling 1 (800) 894-4563. 13. Questions in regards to the application of Polyglass products should be directed to our Technical Services Department at 1 (800) 894-4563. 14. Polyglass recommends that applicators follow good roofing practices and applicable procedures as outlined by the National Roofing Contractors Association (NRCA). PLEASE CHECK WITH LOCAL BUILDING CODES REGARDING LIMITATIONS OF SPECIFIC APPLICATIONS. LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND RECOMMENDATIONS. END OF THIS ACCEPTANCE MIAMI•DADE COUNTY APPROVED .... • . •••• • • • .. . .. • .. • . •. • . • .. • . • . .... .. • . .. . .... • .. .. . • • . . .... . • .. . .. . • . . • •. . • .. .. • ... • • • • • NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 8 of 8 MIAMI COUNTY DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) ICP Adhesives and Sealants, Inc. 12505 NW 44th Street Coral Springs, FL. 33065 MIAMI-DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175-2474 T (786)315-2590 F (786) 315-2599 www.miamidade.2ov/economv 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 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. RER 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: ICP Adhesives Polyset® AH-160• •• • •• • • •• • LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and followeng 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 Alt% 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 changt 1i?:11t: 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 seeetio .ef. 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 renews NOA 16-0315.01 and consists of pages 1 through 11. The submitted documentation was reviewed by Alex Tigera. MIAMI DADE COUNTY APPROVED NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 1 of 11 • • • • • • • • • • .. • • • • • .• • •• • • • • • •• .• • • • • • • • • • •• • • • •• • ROOFING COMPONENT APPROVAL: Category: Sub Category: Materials: Roofing Roof tile adhesive Polyurethane SCOPE: This approves ICP Adhesives Polyset® AH-160 as manufactured by ICP Adhesives and Sealants, Inc. as described in this Notice of Acceptance. For the locations where the design pressure requirements, as determined by'applicable building code, do not exceed the design pressure values obtained by calculations in compliance with Roofmg Application Standard RAS 127. For use with approved flat, low, and high profile roof tile systems using ICP Adhesives Polyset® AH-160. PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test Product Description Specifications ICP Adhesives N/A TAS 101 Two component polyurethane foam adhesive Polyset®AH-160 ICP Adhesives Foam N/A Dispensing Equipment Dispenser RTF1000 ICP Adhesives ProPack® N/A Dispensing Equipment 30 & 100 PRODUCTS MANUFACTURED BY OTHERS: • • • . . •• • Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list attachment resistance values with the use of ICP Adhesives Polyset® AH-160 roof tile adhesive. MANUFACTURING LOCATION: 1. Tomball, TX. PHYSICAL PROPERTIES: Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Closed Cell Content Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 ASTM D 2856 Results 1.6 lbs./ft.' 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs./Fte 3.1 Perm / Inch +0.07% Volume Change @ -40° F., 2 weeks +6.0% Volume Change @158°F., 100% Humidity, 2 weeks 86% • • • • •••• • • .• . • • • • • • 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. MIAMFDADE COUNTY APPROVED • • • . • .• • NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 2 of 11 • • • • • • •••. •. • • • • • •• • •• • • • • • •• •. • • • • • .. • • •• • • • •• • EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date Center for Applied Engineering #94-060 TAS 101 04/08/94 257818-1PA 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 Southwest Research Institute Trinity Engineering Celotex Corp. Testing Services LIMITATIONS: ASTM E 108 04/30/93 01-6743-011 ASTM E 108 01-6739-062b[1] ASTM E 84 11/16/94 01/16/95 7050.02.96-1 TAS 114 03/14/96 P36700.04.12 ASTM D 1623 04/18/12 P39740.02.12 TAS 101 02/21/12 TAS 123 528454-2-1 528454-9-1 528454-10-1 520109-1 520109-2 520109-3 520109-6 520109-7 520191-1 520109-2-1 TAS 101 10/23/98 •.•• • • • • ••.• • • • • •• • •• • • TAS 101 12/28/9$ • • •• • • •• • • • • .••• •• • • • • • • • • •••• • •• TAS 101 03/02/90 • • .. •• • • • •• • • • • • •• • • • • • • • • • • • 1. Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. • . . • • 2. ICP Adhesives Polyset® 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 ICP Adhesives Polyset® AH-160 roof tile adhesive with their tile assemblies shall test in accordance with TAS 101. " 5. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 61G20-3 of the Florida Administrative Code. MIAMI•DADE COUNTY APPROVED NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 3 of 11 • • • .• • • • • • • •• • INSTALLATION: 1. ICP Adhesives Polyset® AH-160 may be used with any roof tile assembly having a current NOA that lists attachment resistance values with the use of ICP Adhesives Polyset® AH-160. 2. ICP Adhesives Polyset® 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 ICP Adhesives Polyset® AH-160 shall provide sufficient attachment resistance to meet or exceed the resistance value 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. ICP Adhesives Polyset® AH-160 and its components shall be installed in accordance with Roofing Application Standard RAS 120, and ICP Adhesives and Sealants, Inc.'s Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by ICP Adhesives and Sealants, Inc. ICP Adhesives and Sealants, Inc. shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the ICP Adhesives Foam Dispenser RTF1000 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). 6. ICP Adhesives Polyset® AH-160 shall be applied with ICP Adhesives Foam Dispenser RTF1000 or ICP Adhesives ProPack® 30 & 100 dispensing equipment only. 7. ICP Adhesives Polyset® AH-160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 1 to 2 minutes after ICP Adhesives Polyset® AH-160 has been dispensed. • • • • • • 9. ICP Adhesives Polyset® AH-160 placement and minimum patty weight shall be in accordance with the : • • • • 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. " ' • • • • ' • • • • • MIAMFDADE COUNTY APPROVED • • • • • • •• • • • • • • • • • • • •• •• • • • • • • •• •• • •• • • • • • • • • • • •_ • •• • • • • • • • • •• • •• • • • • • • NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 4 of 11 Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Minimum Paddy Contact Area Minimum Paddy Gram Weight Eave Course - Flat, Low, ]High Profiles All Eave Course 17-23 sq. inches 45-65 Flat, Low, High Profiles #1 17-23 sq. inches 45-65 Flat Profile - #2 10-12 sq. inches 30 Low Profile #2 12-14 sq. inches 30 High Profile #2 17-19 sq. inches 30 Flat, Low, High Profiles #3 Two Paddys: 8-9 sq. inches at head of tile 9-11 sq. inches at overlap 12 grams per paddy Two -Piece Barrel (Cap Tile) Two Piece 2 Beads (1 each longitudinal edge) 20-25 sq. inches each bead 17 grams per bead Two Piece Barrel (Pan Tile) Two Piece 65-70 sq. inches 34 grams under pan LABELING: • • • •• • • All approved products listed herein shall be labeled and shall bear the imprint or identifiable marking of the • • • • manufacturer's name or logo and following statement: "Miami -Dade County Product Control Approved" or the Mid • • Dade County Product Control Seal as shown below. MANMADE COUNTY AP ED • • •• •• • • • • • BUILDING PERMIT REQUIREMENTS: • .• • As required by the Building Official or applicable building code in order to properly evaluate the installation of this • •• system. MIAMFDADE COUNTY APPROVED NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 5 of 11 • • • • • • • • • • •• • . • • • • • • •• • • •• • • • • . • • .. •• • • . • • •• • • • • • • • . • • • .. • • • • ADHESIVE PLACEMENT DETAIL # 1 Nan through plastk comsat wear lenwath TIM) luhen required) • N. Jrr'7 i �ti•,„yam • , vv ,>. Eau* foune, ./• ,•y`.p�•`''' f•'` ▪ y 41in Tg MIAMI OADE COUNTY APPROVED Flat/Low Profile Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown, under the strengthening rib closest to the overlock of the tile being set. 2. Continue in same manner. Insure approximately 17 (109.7 cm2) — 23 (148.4 cm2) square inch adhesive contact with the underside of the tile. Medium Profile / Double Pan Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) lam. • • paddy onto the underlayment positioned as shear • under the pan portion of the tile closest to the overlock of the tile being set. • sass 2. Continue in same manner. Insure approximafelX 1'Z • (109.7 cm2) — 23 (148.4 cm2) square inch adl e„si' • • contact with the underside of the tile. • • • • • • • . . • • • . . •• • High Profile / Single Pan Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under the pan portion of the tile closest to the overlock of the tile being set. 2. Continue in same manner. Insure approximately 17 (109.7 cm2) — 23 (148.4 cm2) square inch adhesive contact with the underside of the tile. NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 6 of 11 .•.• •.•• • .. • • • . • . • .. •• . • • • • • • .• •• • • • • • •• • • • • • • • • • •• • . • • • • •• • ADHESIVE PLACEMENT DETAIL # 2 Nail through plastic cement tuhen reauircedl �t -Paddy 4Beneath lila) Uradothsyntinil MIAMFDADE COUNTY APPROVED Flat/Low Profile Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under the strengthening rib of the tile closest to the overlock of the tile being set. Insure approximately 17 (109.7 cm2) — 23 (148.4 cm2) square inch adhesive contact with the underside of the tile. 2. At the second course, apply a minimum 2" (50.8mm) x 7" (177.8 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under the strengthening rib closest to the overlock of the tile being set. 3. Continue in same manner Insure approximately 10" (64.5 cm2) - 12 (77.4 cm2) square inch adhesive contact with the underside of the tile. • • • • • •• • Medium Profile / Double Pan Tile 1. Starting at the eave course, apply a minimum 2''(5e.%. mm) x 10" (254 nun) x 1" (25.4 mm) foam paddy' • • onto the underlayment positioned as shown unAC ltPie pan portion of the tile closest to the overlock of thee • tile being set. Insure approximately 17 (109.7 ems•+ • 23 (148.4 cm2) square inch adhesive contact web the • underside of the tile. • • • • • •• • 2. At the second course, apply a minimum 2" (50.8mm) x 7" (177.8 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under the pan portion of the tile closest to the overlock of the tile being set. 3. Continue in same manner. Insure approximately 12" (77.4 cm2) - 14 (90.3 cm2) square inch adhesive contact with the underside of the tile. (Instructions continued on next page) NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 7 of 11 • • •• • • • • •• • • • •• • •• • • • • • •• •• • • • • • .• • • • •• • • • • •• • ADHESIVE PLACEMENT DETAIL # 2 (CONTINUED) Nail through plastiic cement—, (when moulted) Undw4rn.n Tin lit. Battens optional :' . • fP.ddy IBn.*ah Tile) "Fascia %Woo:a eb closure Drip edge MIAMFDADE COUNTY APPROVED High Profile / Single Pan Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under the pan portion of the tile closest to the overlock of the tile being set. Insure approximately 17 (109.7 cm2) — 23 (148.4 cm2) square inch adhesive contact with the underside of the tile. 2. At the second course, apply a minimum 2" (50.8mm) x 7" (177.8 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under the pan portion of the tile closest to the overlock of the tile being set. 3. Continue in same manner. Insure approximately 17" (109.7 cm2) - 19 (122.6 cm2) square inch adhesive • "" • contact with the underside of the tile. • •'•" • • •. • • • • • • • •• • • • • • • • • •• • • • • • • • • • • • • •• •• • • •• •• •• • • • • • •• • • • • • • • • . • • • • • • • • • •• • NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 8 of 11 • • • •• • • • • • • ADHESIVE PLACEMENT DETAIL # 3 Flat/Low Profile Tile Medium Profile Tile MIAMIOADE COUNTY APPROVED 1. On the eave course only, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown, under the strengthening rib for flat tile or under the pan portion of the tile for low or high profile tile closest to the overlock of the tile being set. Leave approximately 4" (101.6 mm) up from the eave edge free of foam to prevent the expanded adhesive from blocking the weep holes. Insure approximately 17-23 in2 (109.7-148.4 cm2) of adhesive contact with the underside of the tile 2. Apply a4"(101.6mm) x4"(1O1.6mm) x1"(25.4 mm) foam paddy onto the underlayment just below the second course line positioned foam paddy under the strengthening rib for flat tile, or under the pan portion of the tile, closest to the underlock for the second course tile to be installed. Insur1 • approximately 8-9 inZ (51.6-58.1 cm2) of adhesive • contact with the underside of the tile. (Instructions continued on next page) • • • • • .••• .• • • • • • • •• • • • •••. •• • • • • • • • • • • • • • •• •• • • • • • • •• •• • •• • • • • • • • • • • • • • • • • • • •• • NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 9 of 11 • • • •• • • • • • • •• • ADHESIVE PLACEMENT DETAIL # 3 (CONTINUED) High Profile Tile MIAMFDADE COUNTY APPROVED 3. Also apply a2"(50.8mm) x4"(101.6mm) x3/e" (19 mm) paddy on top of the eave course tile surface as shown, on top of the strengthening rib for flat tile or on top of the pan portion of the tile, closest to the underlock of the first course of tile. Install second course of tile. Insure approximately 9 (58.1 cm2) - 11 (71cm2) square inch adhesive contact with the underside of the tile at the overlap and 7 (45.2 cm2) - 9 (58.1 cm2) square inch adhesive contact with the underside of the tile at the head of the tile. Continue in same manner. • • •• • • • • •••• • • • • •• • •• • • • • • • • •• • • • • •••• •• • • • • • • • • •••• • •• • • •• •• • • • • • • • • • • •• • NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 10 of 11 •• • • • • • •• • • • • • • • • • • • •• • • • • • • ADHESIVE PLACEMENT DETAIL TWO PIECE BARREL 1) Place enough adhesive to achieve 6S to 70 sq. In. in contact with the pan tik. 2) Turn coven upside down. Place adhesive in to 1 in. from outside edge of cover tile. Then install the tile. Ensure 20 to 25 sq. in. contact area. Underlayment Eave closure (molar shown) Weephole Fascia Board Steep pitch applkations (when required) Sheathing Remove top portion of the cave course cover tile. Abut to second course of pan tiles. Ensure eave end of pan and cover tiles are flush at eave line. Two Piece Barrel - High Profile Tile Two Piece Barrel (Cap and Pan) Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under two adjacent pan tiles. Support eave tiles from rocking until adhesive has a chance to cure. 2. Continue in same manner bringing`two pan courses up toward the ridge. Insure approximately 65 (419.4 cm2) — 70 (451.6 cm2) square inch adhesive contact with the underside of the pan tile. 3. Turn covers upside down exposing the underside of the tile. Apply a minimum 1" (25.4 mm) x 10" (254 mm) bead of adhesive directly on the••innej• . edge of each side of the cover tile. Leave • • • approximately 3/4" (19 mm) to 1" (25.4 mix). • • • from the outside edge of the tile, inward, fsoeo '• • foam to allow for expansion. • • • • '•.••� 4. Turn cover tile over after foam is applied 4q4.. • place onto pan tile course. Insure a minimy►b f • • 20 (129 cm2) - 25 (161.3 cm2) square inch.. • • • contact area on each side of the cover tile to tie • pan tile. Continue in same manner. Trim away • any cured exposed foam adhesive. Pointing of. •. longitudinal edges of the cover tiles are considered optional. 5. When additional nailing is required, 2" (50.8 mm) x 4" (101.6 mm) milers or the tie wire system using galvanized, stainless steel, or copper wire and compatible nails may be used. END OF THIS ACCEPTANCE NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 11 of 11 •.•• • • •••• •• • • • • • .• • .• • • . • • •. •• • • • • • •• • • • • •• • • • • •. • 1524 HIGH VELOCITY HURRICANE ZONES SECTION REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner ant the contractor. The owner's initial in the designated space indicates that the item has been explained. .... • • 2. Renailing wood decks: When replacing roofing, the existing woodboftieck rriay have to be renailed in accordance with the current provisions of Section R4403. (The rob?tli$& is usually concealed prior to removing the existing roof system). 4. 6. . .. . .... • • •• . . . . . Exposed Ceiling: Exposed, open beam ceilings are where the undargicl of the root decking • can be viewed from below. The owner may wish to maintain the architectural a as tenf e; therefo, • • roofing nail penetration of the underside of the decking may not be acceptable. This provides tt�EA4ion of maintaining the appearance.• . .. . •• • • . • ••• . Overflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not overloaded from a buildup of water. Perimeter/edge wall or other roof extension may block this dis �f overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow in accordance with the requirements of Sections R4402, R4403 and R4413. Signature Date Con rector Signature Date f Ne % s r Property Address Revised on 7/9/2009 LD;07/01/2015; Permit Number • •