The URL can be used to link to this page

RF-19-2365Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address • issue Date:10/22/2019 Parcel Number 55 NE 97TH ST, Miami Shores, FL 33138 1132060130990 Contacts Permit NO.. RF-10-19-2366 Permit Type: Roof Work Classification: Tile Permit Status: Approved Expiration: 04/20/2020 DINO & IRENE PERAGALLO Owner STATEWIDE ROOFING INC Contractor 55 NE 97 ST, MIAMI SHORES, FL 33138 KENNITH MULLINS Other: 3059955224 4611 S UNIVERSITY DR, DAVIE, FL 33328 Business: 2562398900 charlie6552@yahoo.com Ins Description: RE -ROOF TILE (BROWN) Valuation: $ 4,000.00 Inspection ion Requests: 4949 TotalSq Feet: 600.00 Fees Amount Application Fee - Other $50.00 CCF $2.40 DBPR Fee $3.75 DCA Fee $2.50 Education Surcharge $0.80 Roofing Fee $200.00 Scanning Fee $9.00 Technology Fee $6.25 Total: $274.70 Building Department Copy Payments Date Paid Amt Paid Total Fees $274.70 Cash 10/08/2019 $50.00 Cash 10/22/2019 $224.70 Amount Due: $0.00 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, MEC ICA , WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the fon regulating construction and zoning. Futhermore, I > accurate and that all work will be done in compliance with all applicable laws named contractor to do the work stated. Authorized Signature: Owner / Applicant / / Agent Date October 22, 2019 Page 2 of 2 1 , 0 BUILDING PERMIT APPLICATION Miami Shores Village Building Department OCT 8 2619 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 FBC 20TIC i Master Permit No. TY ❑BUILDING ❑ ELECTRIC Q ROOFING ❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS JOB ADDRESS: 55 NE 97 Street Sub Permit No. ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: 11 -3206-13-0990 is the Building Historically Designated: Yes NO X Occupancy Type: GARA( Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): DI NO AND IRENE PERAGALLO Phone#: 9S4__684— 2-071 Address:55 NE 97 STREET City: MIAMI SHORES Tenant/Lessee Name: Email: State: FL Zip: 33138 Phone#: CONTRACTOR: Company Name: STATEWIDE ROOFING, INC. Address: 4611 S. UNIVERSITY DRIVE City: DAVIE State: FL Qualifier Name: KEN MULLINS State Certification or Registration M CCCO29572 hone#: 256-239-8900 hone#: Certificate of Competency M DESIGNER: Architect/Engineer: Phone#: Address: Value of Work for this Permit: $4,000 Type of Work: ❑ Addition ❑ Alteration Description of work: RE -ROOF TILE City: State: Square/Linear Footage of Work: 600 ❑ New M Repair/Replace 33328 Zip: ❑ Demolition Specify color of color thru tile: b1'0w P'\- Submittal Fee & i Permit Fee $ as D CCF $ � . TV CO/CC $ Scanning Fee $ 9. ""bD Radon Fee $ Q• 0 DBrP�R $ 3 - �S Notary $ Technology Fee $ Vr - X5 Training/Education Fee $ d • 8 U Double Fee $ Structural Reviews $ Bond $ 600 TOTAL FEE NOW DUE $ �a • �D (Revised02/24/2014) --+aL - _� 0 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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. Signature 4 OWNER or AGENT The foregoing instrument was acknowledged before me this day of 20 by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Si Print: Seal: e�'NrBrendaPuLerc sow ar Ftarfde �1 ►SAY CWwAwlan GG 294353 pia ExWnN 02111=3 ****************************** Cf APPROVED BY Signature _,=:-)1eL \ CONTRACTOR The foregoing instrument was acknowledged before me this day of OCiTDBe t — 20 / -1.gby wh is personally k wn to me or who has produced identification and who did take an oath. NOTARY Seal: } BrauLb/e se.r ar inorta, MY Conn ' Won GG 294383 as ************************************************************* Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Property Search Application - Miami -Dade County Page 1 of 1 OFFICE OF THE PROPERTY APPRAISER Summary Report Property Information Folio: 11-3206-013-0990 Property Address: 55 NE 97 ST Miami Shores, FL 33138-2330 Owner DINO P PERAGALLO IRENE PERAGALLO Mailing Address 55 NE 97TH ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1100 SGL FAMILY - 2301-2500 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 4/3/0 Floors 1 Living Units 1 Actual Area 2,396 Sq.Ft Living Area 1,808 Sq.Ft Adjusted Area 2,361 Sq.Ft Lot Size 8,625 Sq.Ft Year Built Multiple (See Building Info.) Assessment Information Year 2019 2018 2017 Land Value $258,854 $215,711 $215,711 Building Value $207,134 $209,480 $211,826 XF Value $4,448 $4,475 $4,502 Market Value $470,436 $429,666 $432,039 Assessed Value $437,829 $429,666 $432,039 Benefits Information Benefit Type 2019 2018 2017 Save Our Homes Cap Assessment Reduction $32,607 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). Short Legal Description MIAMI SHORES SEC 1 AMD PB 10-70 LOT 17 W1/2 LOT 18 BLK 7 LOT SIZE 75.000 X 115 OR 16447-0765 0794 1 Generated On : 9/30/2019 Taxable Value Information 2019 2018 2017 County Exemption Value $50,000 $50,000 $50,000 Taxable Value $387,829 $379,666 $382,039 School Board Exemption Value $25,000 $25,000 $25,000 Taxable Value $412,829 $404,666 $407,039 City Exemption Value $50,000 $50,000 $50,000 Taxable Value $387,829 $379,666 $382,039 Regional Exemption Value 1 $50,000 $50,000 $50,000 Taxable Value $387,829 $379,666 $382,039 Sales Information Previous Sale Price OR Book -Page Qualification Description 06/15/2015 $565,000 29667-2684 Qual by exam of deed 07/01/1994 $122,000 16447-0765 Sales which are qualified 06/01/1983 $90,000 11817-0133 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/disciaimer.asp Version: https://www.miamidade.gov/Apps/PA/property search/ 9/30/2019 October 1, 2019 RE: 55NE 97 Street STATEWIDE ROOFING, INC. 4611 &UNIVERSITY DRIVE DAVIE, FL 33328 PHONE: 256-239-8900 CCC#: 029572 CONTRACT Drake Roofing Services, Inc. has been contracted to remove and replace roof on 600 square foot structure in the back of property located at 55 NE 97 Street. The value of work to be done is $4,000 Statewide Roofing, Inc. Drake Roofing Services, Inc. Miami Shores Village 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 Date: 10050 NE 2nd Ave Miami Shores, A 33138 _ Re: Owner's Name: Property Address: S'S 101 9 7 S 7 . Roofing Permit Number: r'aGe/l b Dear Building Official: I S " 4ra certify that I am not required to retrofit the roof to wall connections of my building because: The just valuation for the structure for purpose of ad valorem taxation is less than $300,000.00. Please attach proof of ad valorem taxation. o The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions of 1994 edition of the South Florida Building Code (1994 SFBC) foe— r a' ignature Print Name State of Florida County of Dade The undersigned, being the first duly sworn, deposes and says that he/she is the owner for the above property mentioned. Sworn to and subscribed before me this day of 00--t D A r- , J DI Y Notary Public, Sate of Florida at Large 80 Ll PMsw.orftartdr My Conn�Non GG 2ti M a ExOm 02H 1=3 When the just valuation of the structure for purpose of ad valorem taxation is equal to or re than $300,000.00, an i a , SFBC. Then you must provide a building application from a General Contractor for the Roof to Wall connection Hurricane Mitigation. Revised on 5/21/2009 STATROO-01 NBEDIA ACORO® DATE (MM/DD/YWY) �� CERTIFICATE OF LIABILITY INSURANCE F10/9/2019 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(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NWCT C & C Insurance, Inc. P�rN , Ext : (954 431-2008 Fax 1921 NW 150 Ave, Suite 101 ) ac, No►:(954) 704-0507 Pembroke Pines, FL 33028 n p" : inf candcinsurance.com INSURED Statewide Roofing Inc 5807 Dawson Street #14 Hollywood, FL 33023 INSURERA:AKI.ri 2fi"tLIA 1 LT In INSURER B : INSURER C : I I INSURER F : I I rnvc0A1--cc CCDTICIr ATF IUI IMRGR• RFVISInNI NI IMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSD SUER WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRA X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR AGLOO57356-00 12/30/2018 12/30/2019 EACH OCCURRENCE $ 300,000 DDPREMISES -AAMA E TO ENTE once $ 100,000 MED EXP (Any one person) $ 10,000 GEN'L X PERSONAL & ADV INJURY $ 300,000 AGGREGATE LIMIT APPLIES PER: POLICY �� JEa LOC OTHER: GENERAL AGGREGATE $ 300,000 PRODUCTS - COMP/OP AGG $ _ 300,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS �p AUTOS ONLY AUTOS ONLY Ea COMBINEDSINGLE LIMIT $ BODILY INJURY Per erson) $ BODILY INJURY (Per accident $ PROPERTYraccident)PAMAGE $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE $ $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE j j Mend 1M In NHR EXCLUDED? L ( t ry ) Ii yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- .STATSlTE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Addttional Remarks Schedule, may be attached if more space Is required) Ken Mullins, License number CCC 029672, Roofing Contractor ^CMTId/^A'rM Unl noo r`AIIf'=I I ATIr11d SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Miami Shores Village Building Department 9 9 pa THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2 Avenue Miami Shores, FL 33138 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) 9)1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DBPR - DRAKE, DAVID C; Doing Business As: DRAKE ROOFING SERVICES, INC.,— Page I of I 10:09:53 AM 101252018 Licensee Details Licensee Information Name: DRAKE, DAVID C (Primary Name) DRAKE ROOFING SERVICES, INC. (DBA Name) Main Address: 5240 SW 88 TERRACE COOPER CITY Florida 33328 County: BROWARD License Mailing: Licensel-ocation : License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business Alternate Names Certified Roofing Contractor Cert Roofing CCC1327504 Current,Active 07/31/2006 08/31/2020 Qualification Effective 07/31/2006 View Related License Information View License Complaint 2601 Blair Stone Road Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer. Copyright 2007-2010 State of Florida. Privacy Statement Under Florida law, email addresses are public records. If you do not want your email address released in response to a puok-records request, do not send electronic mail to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. *Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. roust provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email addresses are public record. If you do not wish to supply a personal address, please provide the Department with an email address which can be made available to the public. uIA,r-nm/T irPncPT)Ptail acn9RTT)=k.id=R32RORR254748F2EB4... 10/25/2018 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2019 THROUGH SEPTEMBER 30, 2020 DBA:DRAKE ROOFING SERVICES INC Business Name: Owner Name: DAVID DRAKE Business Location: 1480 NE 24 ST POMPANO BEACH Business Phone: Receipt #:ROOFING5-2 6 SHEET Business Type: Business Opened:01/21/2015 State/County/Cert/Reg:000 13 2 7 5 0 4 Exemption Code: METAL CONTRACTOR Rooms Seats Employees Machines Professionals 7 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non -regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: DRAKE ROOFING SERVICES INC Receipt #WWW-18-00178944 1480 NE 24 ST Paid 07/09/2019 27.00 POMPANO BEACH, FL 33064 U.S.A. 2019 -2020 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1, 2019 THROUGH SEPTEMBER 30, 2020 DBA:DRAKE ROOFING SERVICES INC Business Name: Owner Name: DAVID DRAKE Business Location: 1480 NE 24 ST POMPANO BEACH Business Phone: Receipt #: 185-266755 Business Type: ROOFING/SHEET METAL CONTRACTOR Business Opened: 0 1 / 2 1 / 2 0 15 State/Cou my/Cert/Reg: CCC 13 27 5 0 4 Exemption Code: Rooms Seats Employees Machines Professionals 7 Signature For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee I NSF Fee I Penalty I Prior Years I Collection Cost Total Paid 27.00 0.001 0.001 0.001 0.001 0.00 27.00 Receipt #WWW-18-00178944 Paid 07/09/2019 27.00 ACC> o® CERTIFICATE OF LIABILITY INSURANCE `� DATE 10/0/201/2019 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(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Bouchard Insurance for WBS PO Box 6090 Clearwater, FL 3375MO90 CONTACT NAME: PHONE (866) 293-3600 ext. 623 JC No): E-MAIL ADDRESS: INSURER S AFFORDING COVERAGE NAIC p INSURER A: American Zurich Insurance Company i 40142 INSURED Workforce Business Services, Inc. Alt Emp: Drake Roofing Services Inc. 1401 Manatee Ave. West Ste 600 INSURER B : INSURER C Bradenton, FL 34205-6708 INSURER D : INSURER E : INSURER F : rnvcowr_me d`CDTICUTATG kIHUF1G0•1RFI n79g75g71 REVISION NUMBER: vTHIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL a POLICY NUMBER POLICY EFF MMID Y EXP LIMITS COMMERCIAL GENERAL EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO REN PR MI E Ea occurrence $ MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ POLICY ❑ JEC - LOC OTHER: LIABILITY COMBINDAUTOMOBILE Ea accidentSINGLE LIMI $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per accident $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTIONS $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBEREXCLUDED' (Mandatory in NH) NIA WC90-00-818-08 12/31/2018 12/31/2019 _ X STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE E $ 1,000 000 E.LDISEASE-POLICY LIMIT 1 $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below Location Coverage Period: 12/31/2018 12/31/2019 Client# 054525 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Coverage is provided for Drake Roofing Services Inc. only those co -employees 1480 NE 24th St of, but not subcontractors Pompano Beach, FL 33064 to: GEK 1 II UA 1 t KUL.UtK `+^��+r-r-� ^ w�• — - Miami Shores Village Building Dept 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE W TMao-LUIa Pk%.%JKU I.IJRrV RN 1 IVIY. •t11 rlu"Lr rts:furvau. ACORD 25 (20161031 The ACORD name and loao are registered marks of ACORD ■ Roof Re700-O��FF 0 Recovering U Repair ' •1 SYSTEM INFORMATION wn Douvf Arno /Q1;1 amen 3lened Rnef Aram (SR Total (SF z Section B (Roof Planl tch Roof Plarr Illustrate all levels and sections, roof drains, scuppers, a Peers and overflow drains. Include dimensions of sections and levels, itKV dimensions of elevated pressure zones and location of parapets. ROOF ASSEMBLIES AND ROOFTOP STRUCTURES SECTION 1525 HIGH -VELOCITY HURRICANE ZONES - UNIFORM PERMIT APPLICATION Florida Building Code 6th Edition (2017) High -Velocity Hurricane Zone Uniform Permit Application Form. INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW:"' Roof System Required Sections of the Permit Application Form Attachments Aagtyrea See List Bplpyv Low Slope Application A,B,C 1,2,3,4,5,6,7 Prescriptive BUR-RAS 150 A,B,C 4,5,6,7 Asphaltic Shingles A,B,D 1,2,4,5,6,7 • • • Concrete or Clay Tile A B D,E 1,2,3,4,5,6,7 Metal Roofs A,B,D 1,2,3,4,5,6,7 Wood Shingles and Shakes A,B,D 1,2,4,5,6,7 Other As Applicable 1,2,3,4,5,6,7 ATTACHMENTS REQUIRED: 1. Fire Directory Listing Page 2. From Product Approval: Front Page Specific System Description Specific System Limitations General Limitations Applicable Detail Drawings 3. Design Calculations per Chapter 16, or If Applicable, RAS 127 or RAS 128 4. Other Component of Product Approval 5. Municipal Permit Application 6. Owners Notification for Roofing Considerations (Reroofing Only) 7. Any Required Roof Testing/Calculation Documentation ••.•i«. • • FLORIDA BUILDING CODE 6th Edition (2017) — BUILDING 5.31 r Florida Building Code 6th Edition (2017) High -Velocity Hurricane Zone Uniform Permit Application Form Section D %eep Sloped Roof System) Roof -System Manufacturer: G' L Notice of Acceptance Number: Minimum Design Wind Pressures, if Applicable (From RAS 127 or CaicuM90p): P1: P2:- P3: . . �A') ••••• Maximum Design Pressure .... From the NOA Specific S stem : . • • • ' ....' • .... • � • � • Method of file attachment: (�,/o r'� � Lr p • • • • Steep Sloped Roof fystem Description Deck Type:, Roof Slope: �.: 12 Ridge ventilation? Mean Roof Height: 0 t� -CO A-) A ner Type & Spacing: le ,, l ! Adhesive Type EEC,P ;►' ype Cap Sheet: I . f & Size Drip R3G G GG !- ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code 6th Edition (2017) High -Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compare the values for Mr with the values from Mf. If the Mf values arc greater than or equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. Method 1 "Moment Based Tile Calculations Per RAS 12T' (PI: x x _ ) - Mg: = Mrl Product Approval Mf (P2: x) _ ) - Mg: = Mr2 Product Approval Mf (P3: x ,1 = ) - Mg: = Mr3 Product Approval Mf •••••• Method 2 "Simplified Tile Calculations Per Table Belo • • • Required Moment of Resistance (Mr) From Table Below ), Product Approval M f • • • • • • • • • • • • Mr required Moment Resistance* • • • • • • Mean Roof Height -• • • .. .• • • Roof Slope 15 20' 25' 30' • • • 40' • • 2:12 34.4 36.6 38.2 39.7 • •• 0 42.2 0 • 2 32.2 34.4 36.0 37.4 • • • • • 39.8 • 4:12 30.4 32.2 33.8 35.1 • • • 37.3 • 5:12 28.4 30.1 31.6 32.8 i • • • 34.9 • 6:12 26.4 28.0 29.4 30.5 32.4 • • 7:12 24.4 25.9 27.1 28.2 30.0 *Must be used in conjunction with a list of moment based tile systems endorsed by the 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 the attachment method is acceptable. Method 3 "Moment Based Tile Calculations Per RAS 127" (PI: x L = x w: = _) - W: x cos B = Frl Product Approval F' (P,: x L = x w: = ) - W: x cos B = Fr2 Product Approval F (P,: x L - x w: = 1- W: x cos 0 = F - Pmdur1 Armour] W Where to Obtain Information Description Symbol Where to find Design Pressure PI or P2 or P3 RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7 Mean Roof Height H Job Site Roof Slope 0 Job Site Aerodynamic Multiplier x Product Approval Restoring Moment due to Gravity MB Product Approval Attachment Resistance M Product Approval Required Moment Resistance M. Calculated Minimum Attachment Resistance F Product Approval Required Uplift Resistance Fr Calculated Average Tile Weight W Product Approval Tile Dimensions L = lengthProduct W = width Approval All calculations must be submitted to the building official at the time of permit application. FLORIDA BUILDING CODE 6th Edition (2017) - BUILDING 15.35 SECTION 1524 HIGH VELOCITY HURRICANE ZONES — 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.-ORvAwner's initial in the designated space indicates that the item has been explained. • • • "":' ...... .... ...... 2. Renailing wood decks: When replacing roofing, the existing wgodroof deck jrWNave to •• •: be renailed in accordance with the current provisions of Section R4403. (The ro'bf tleck is usual? • • • • • • concealed prior to removing the existing roof system). • • • • • • • • • • • • • • .. .. ... ...... 4. Exposed Ceiling: Exposed, open beam ceilings are where the underside of the teot decking, • • •, c viewed from below. The owner may wish to maintain the architectural 4pWarince; therekire, :"": roo mg nail penetration of the underside of the decking may not be acceptable. This provides4ii® option of maintaining the appearance. 6. 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 discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sections R4402, R4403 and R4413. �''� , 9 �Vs Signature Date ALE 2 Property Address Revised on 7/9/2009 LD;07/01/2015; 4/C;actor Signature Date Permit Number r4f 1'�G.4 F�t COUNTY MIAMI-DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) Miami, Florida 33175-2474 BOARD AND CODE ADMINISTRATION DIVISION T (786) 315-2590 F (786) 315-2599 NOTICE OF ACCEPTANCE (NOA) w�v.v.miamidade.eov/economy Eagle Roofing Products LLC 1575 East C.R. 470 Sumterville, FL 33585 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction VWpo ils. The documentation submitted has been reviewed and accepted by Miami -Dade County RER-Prodvct.Cont?ol Section td Dt•; • used in Miami -Dade Countyand other areas where allowed b the Authority Having Juris • AH • .' • Y tY g �tFx'PA� �:...' ....:. This NOA shall not be valid after the expiration date stated below. The Miami -Dade County 10auct Control SectiJQ. . • ; (in Miami -Dade County) and/or the AHJ (in areas other than Miami -Dade County) reserve NeVeight to have'this ' product or material tested for quality assurance purposes. If this product or material fails t . • in • acce tea'' P q tY P rP P 4 AF�R� �� P ..... manner, the manufacturer will incur the expense of such testing and the AHJ may immediw?y Ovoke,'tpp8ify, or • suspend the use of such product or material within their jurisdiction. RER reserves the rigfittecevoke this.acceptance,.' if it is determined by Miami -Dade County Product Control Section that this product or material fails to;g%e$JJhe • • • • : • requirements of the applicable building code. .'. • This product is approved as described herein, and has been designed to comply with the Floridal3uildir��.Me ' including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Low Profile Concrete 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 revises NOA No.] 7-0822.13and consists of pages I through 9. The submitted documentation was reviewed by Freddy Semina NOA No. 18-0509.18 Expiration Date: 10/05/21 Approval Date: 06/14/18 Page 1 of 9 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Concrete 1. SCOPE: This approves a new roofing system using "Low Profile Concrete Tile" as manufactured by Eagle Roofing Products LLC in Sumterville, FL and described in Section 2 of this Notice of Acceptance. For use in 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 section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION: • • • • • • • • Manufactured by Test ...... .... ...... R aduct Applicant Dimensions Specifications Dese t' . tion • • • • Low Profile Lenght = 17" TAS 112 ... • • Flat profile concretgxQQ file equipp ;d with Me �. Concrete Tile Width = 12 '/4" Type 3a nail holes. For adhesiVvAt, dirr'gtdgdk or Thickness ='V? Class III • • • • • • battened nail -on apekeations. .' Low Profile Lenght = 17" TAS 112 • Flat profile concrett ropf file equipped with jyvp• •; Concrete Tile Width = 12 '/4" Type 3a nail holes. For adhesive set, direct Nrik or ' • Thickness ='V? Class III battened nail -on applications. *000 Low Profile Lenght = 17" TAS 112 Flat profile concrete roof tile with slate finish Concrete Tile Width = 12 'A" Type 3a equipped with two nail holes. For adhesive set, Thickness ='/2" Class III direct deck or battened nail -on applications. Low Profile Lenght = 17" TAS 112 Flat profile concrete roof tile with shake finish Concrete Tile Width = 12 '/4" Type 3a equipped with two nail holes. For adhesive set, Thickness ='V? Class III direct deck or battened nail -on applications. Low Profile Lenght = 17" TAS 112 Flat profile concrete roof the brushed finish Concrete Tile Width = 12'/4" Type 3a equipped with two nail holes. For adhesive set, Thickness = %2" Class III direct deck or battened nail -on applications. Trim Pieces Lenght = varies TAS 112 Accessory trim, concrete roof pieces for use at Width = varies hips, rakes and ridges. Manufactured for each varying thickness tile profile. NOA No. 18-0509.18 Expiration Date: 10/05/21 Approval Date: 06/14/18 Page 2 of 9 2.1 EVIDENCE SUBMITTED: Test Azency Test Identifier PRI Asphalt Technologies ERPF-001-02-01 Redland Technologies 7161-03 Appendix III Redland Technologies 7161-03 Appendix III Redland Technologies 7161-03 Appendix II Redland Technologies P0402 Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Celotex Corporation Testing Service Celotex Corporation Testing Service Walker Engineering, Inc. Walker Engineering, Inc. ATL of South Florida ATL of South Florida PRI Construction Materials Technologies MIAMMADE COUNTY ,...• Letter Dated Aug. 1, 1994 P09647-01 94-084 25-7094-(2, 5, & 8) 25-7183-(5 thru 6) 25-7214-(1, 5, & 8) 25-7487-2 25-7496-(1 & 4) 25-7804-6 520109-1 520111-4 520191-1 Calculations Calculations RT1214.01-15 RT0706.01-17 DAPF-001-02-13 Test Name/Report Date TAS 112 Aug. 2006 Static Uplift Testing Dec. 1991 TAS 102 Static Uplift Testing Dec. 1991 TAS 102(A) Wind Tunnel Testing Dec. 1991 TAS 108 (Nail -On) Withdrawal Resistance Testing of screw vs. Sept. 1993 smooth shank nails . : • • • • • Wind Tunnel Testing — • • *V. 1994 • TAS 108 (Nail -On) : 0 • : • "" 649690 ...... Wind Tunnel Testing ..... .. Aug. A4 "" TAS 108 (Mortar Set) • • • • • • • • . +... Static Uplift Testing•`,,' •, -1Vley 1944 TAS 101 (Mortar Seto:.... 0*000 • Static Uplift Testing :...©ct. l 994'.. • TAS 102 • • • ' Static Uplift Testing • •: •Feb. 1995 TAS 102 Static Uplift Testing March, 1995 TAS 102 Static Uplift Testing Dec. 1995 TAS 102 Static Uplift Testing Dec. 1995 TAS 102 Static Uplift Testing Sep. 1996 TAS 102 Static Uplift Testing Dec. 1998 TAS 101 Static Uplift Testing March 1999 TAS 101 Aerodynamic Multiplier Sep. 2006 Restoring Moments Due to Gravity Sep. 2006 TAS-112 12/17/15 TAS-112 09/25/17 TAS 101 (Adhesive) 11/30/17 NOA No. 18-0509.18 Expiration Date: 10/05/21 Approval Date: 06/14/18 Page 3 of 9 3 LIMITATIONS: 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test in accordance with TAS 106 shall be required, refer to applicable Building Code. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Miami -Dade County Product Control Section for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance With applicable Building Code. ; •' • • • 3.7 All products listed herein shall have a quality assurance audit in accordance with thelMorida Buila!44 Code Rule 61 G20-3 of the Florida Administrative Code. • • • • • • . 4 INSTALLATION: • • • • • + • • .. + 4.1 Eagle Roofing Products LLC Low Profile Flat Concrete Roof Tiles and its componwO.4111 be hWdUed in sWQt„ • compliance with Roofing Application Standard RAS 118, RAS 119 and RAS 120. • • • . •' 4.2 Data For Attachment Calculations • . • ..:. Table 1: Average Weight (W) and Dimensions (I x w) ' Tile Profile Weight-W (Ibf) Length -I (ft) Width-w (ft) Low Profile Flat Tile 11.4 1 1.42 1.03 Table 2: Aerodynamic Multipliers - A (ft3) Tile Profile A (ft3) Batten Application A (ft3) Direct Deck Application Low Profile Flat Tile 0.301 0.278 Table 3: Restoring Moments due to Gravity - Mg (ft-lbf) Tile Profile 3":12" 4":12" 5":12" 6":12" Greater than 7":12" Low Profile Flat Tile Battens Direct Deck Battens 1 Direct Deck Battens Direct I Deck Battens Direct Deck Battens Direct I Deck 1 7.48 7.71 7.37 7.59 1 7.22 1 7.44 1 7.05 7.27 6.86 7.07 Table 4: Attachment Resistance Expressed as a Moment - Mf (ft-lbf) for Nall -On Systems Tile Fastener Type Direct Deck Direct Deck Battens Profile (min 15132" plywood) (min. 19/32" plywood) 2-10d Ring Shank Nails 30.9 38.1 17.2 NOA No. 18-0509.18 Expiration Date: 10/05/21 Approval Date: 06/14/18 Page 4 of 9 Low Profile Flat Tile 1-10d Smooth or Screw Shank Nail 7.3 9.8 4.9 Low Profile Flat Tile 2-10d Smooth or Screw Shank Nails 14.0 18.8 7.4 1 #8 Screw 30.8 30.8 18.2 2 #8 Screw 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 Cli 31.9 31.9 32.2 • . • s • .•.. 2-10d Ring Shank Nails' 50.3 65.5 48.3 '. 1. Installation with a 4" the headlap and fasteners are located a min. of 2%"from,l;e8j of tile. •••• •••. •....• • .•••• . Table 5: Attachment Resistance Expressed as a Moment - ". ""' for Two Patty Adhesive Set Systems ...... • t• Tile Profile Tile Application ;&A- rMnent, •• a i, ance• Low Profile Flat Tile Adhesive' ...• 1 See manufactures component approval for installation requirements. 2 The Dow Chemical Company TileBond Average weight per patty 13.9 grams. 31.3 3 ICP Adhesives PolysetO AH-160 Average weight per patty 8 grams. 31.3 4 DAP Foam Touch N Seal StormBond ® 2 Roof Tile Adhesive. Average weight per paddy 8 grams. 109 Table 6: Attachment Resistance Expressed as a Moment - Mr (ft-lbf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Attachment Resistance Low Profile Flat Tile ICP Adhesives PolysetO AH-160 118.9 ICP Adhesives PolysetO AH-160 40.4 5 Large paddy placement of 45 grams of Po Pro""'. 6 Medium paddy placement of 24 grams of Pol Pro""". Muv MADEcouNTM NOA No. 18-0509.18 Expiration Date: 10/05/21 0918 Approval Date: 06/14/18 Page 5 of 9 Table 7: Attachment Resistance Expressed as a Moment - Mf(ft-lbf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance Low Profile Flat Tile Mortar Set 43.9 7 Tile-Tite Roof Tile Mortar. 5. LABELING : All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo (See Detail Below), or following statement: "Miami -Dade County Product Control Approved". �1 EAGLE�' FLORIDA (LOCATED ON UNDERSIDE OF TILE) OR EAGLE FL (LOCATED ON FRONTSIDE OF TILE) ...... .... ...... .... .... . . .... .... ..... ...... ... ..... ...... . 00 . . . . ...... ...... . ...... 0000 0000 LOW PROFILE CONCRETE ROOF TILE LABEL, SUMTERVILLE PLANT 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 AHJ or applicable Building Code in order to properly evaluate the installation of this system. NOA No. 18-0509.18 Mu APPROVED PPR ED Expiration Date: 10/05/21 I® Approval Date: 06/14/18 Page 6 of 9 PROFILE DRAWING LOW PROFILE ROOF TILE LOW PROFILE ROOF TILE NOA No.18-0509.18 Expiration Date: 10/05/21 Approval Date: 06/14/18 Page 7 of 9 LOW PROFILE ROOF TILE J 1 • � `.• -fib ''\ Y LOW PROFILE ROOF TILE •••• •••• ••••• • NOA No. 18-0509.18 Expiration Date: 10/05/21 Approval Date: 06/14/18 Page 8 of 9 •S.ss• LOW PROFILE ROOF TILE • • • • • o. END OF THIS ACCEPTANCE goes •se• . .•e• •0S• .. • .• . •• •se• NOA No. 18-0509.18 Expiration Date: 10/05/21 Approval Date: 06/14/18 Page 9 of 9 MIAM II; I�E) - MIAMI-DARE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES MR) Miami, Florida 33175-2474 BOARD AND CODE ADMINISTRATION DIVISION T (786)315-2590 F (786) 315-2599 NOTICE OF ACCEPTANCE (NOA) www.miamidade.gov/pr•-^~ ICP Adhesives and Sealants, Inc. 12505 NW 44' Street Coral Springs, FL. 33065 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 t o have this product... or material tested for quality assurance purposes. If this product or material fails to perform inthe aeceptedelnarmer, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, iha0 , or suspetld the use* • • • • of such product or material within their jurisdiction. RER reserves the right to revoke WE acceptancts, if it iS. • • determined by Miami -Dade County Product Control Section that this product or material fails to meet th�iec�utsemen4� .... .. . ..... of the applicable building code. • ...... .. . ..... This product is approved as described herein, and has been designed to comply with the �ftrida 1144 g 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 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 16-0315.01 and consists of pages 1 through 11. The submitted documentation was reviewed by Alex Tigera. CM1AMW1i-1%AMDEC0UN TY ..M M NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 1 of 11 ROOFING COMPONENT APPROVAL: Category: Roofing Sub Category: Roof tile adhesive Materials: 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 Roofing 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 Test Product Description • Dimensions ...... Specifications •'. ICP Adhesives N/A TAS 101 Two component polyuretbaue foatpAlresive� • • " Polyset'AH-160 ' ICP Adhesives Foam N/A Dispensing Equipment • * *"• 4, ' .... • .. • • .. • • Dispenser RTF1000 • • • • • • 000000 . • :. •' 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: Tomball, TX. PHYSICAL PROPERTIES: Property Test Density AS D 1622 Compressive Strength AST D 1621 Tensile Strength AS D 1623 Water Absorption AST�M D 2127 Moisture Vapor Transmission AS}TTM E 96 Dimensional Stability AST M D 2126 Results 1.6 lbs./ft.' 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs./Ft2 3.1 Perm / Inch +0.07% Volume Change @ -400 F., 2 weeks +6.0% Volume Change @I58°F., 100% Humidity, 2 weeks Closed Cell Content AS' M D 2856 86% Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are si bject to normal manufacturing variation. NOA No.: 17-0322.03 MIAMPDADeeouWTlr Expiration Date: 05/10/22 �Fjazi• Approval Date: 04/27/17 Page 2 of 11 EVIDENCE SUBMITTED: Test Aeency Center for Applied Engineering Miles Laboratories Polymers Division Ramtech Laboratories, Inc. Southwest Research Institute Trinity Engineering Celotex Corp. Testing Services Test Identifier #94-060 257818-IPA 25-743 8-3 25-743 8-4 25-7438-7 25-7492 NB-589-631 9637-92 01-6743-011 01-6739-062b[I] 7050.02.96-1 P36700.04.12 P39740.02.12 528454-2-1 528454-9-1 528454-10-1 520109-1 520109-2 520109-3 520109-6 520109-7 520191-1 520109-2-1 Test Name/Report TAS 101 TAS 101 SSTD 11-93 SSTD 11-93 SSTD 11-93 ASTM D 1623 ASTM E 108 ASTM E 108 • ASTM E 84 • • • sees.. TAS 114 •••••• ASTM D 1623 • • • • • • sees TAS 101 •••••• TAS 123 se•.ee sees.. TAS 101 TAS 101 TAS 101 Date 04/08/94 12/16/96 10/25/95 11 /02/95 12/12/95 02/01/94 04/30/93 i l it-mi e O%1095• sees 03/14/96 04f9/1% 024 M 10123/9S sees.. I2/zarss 03/02/99 sees.. sees.. sees.. sees. sees. sees.. sees.. LIMITATIONS: 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 rile 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. NOA No.: 17-0322.03 MIAMI-naoE couNrr Expiration Date: 05/10/22 "' • ' Approval Date: 04/27/17 Page 3 of 11 INSTALLATION: 1. 2. 3. 4. 5. 6. 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. 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. 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. 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. • Calibration of the ICP Adhesives Foam Dispenser RTF 1000 dispensing equipment is recQaired before0application • • • • • • of any adhesive. The mix ratio between the "A" component and the "B" component shall We maintairiffl58uveen • 1.0-1.15 (A): 1.0 (B). • ICP Adhesives Polyset" AH-160 shall be applied with ICP Adhesives Foam Dispenser 4TF4000 or IGA.. • 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 minutel ditV jCP Adhe3iv es • • • • Polyset® AH-160 has been dispensed. 0 0 • ... • • 9. ICP Adhesives Polyset® AH-160 placement and minimum patty weight shall be in accordarice:with the .. • • •; 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. • •:.. NOA No.: 17-0322.03 MIAMMADE COUNTY Expiration Date: 05/10/22 �Fggueglp 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 Minimum Paddy Gram Area Weight Eave Course - Flat, Low, High All Eave Course 17-23 sq. inches 45-65 Profiles 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 12 grams per paddy head of tile 9-11 sq. inches at overlap Two -Piece Barrel (Cap Tile) Two Piece 2 Beads (1 each longitudinal I. • • W grams .bead edge) 20-25 sq. inches each • ..... .... .. bead ..:.. Two Piece Barrel (Pan Tile) Two Piece sq. inches :it • • •� grams r pan • • .0 ...... .. . ..... .. .. .. . ...... LABELING: • • • • • • •' . . . . ...... All approved products listed herein shall be labeled and shall bear the imprint or identifiable niarkia§ of thl manufacturer's name or logo and following statement: "Miami -Dade County Product Control Wroved" of the Miami-: " Dade County Product Control Seal as shown below. • • • • BUILDING PERMIT REQUIREMENTS: As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 5 of 11 ADHESIVE PLACEMENT DETAIL # 1 u 1 •vi1W 'rtr r' L�r:v 4:.: sari •:•Ir- :rear •.tl' �:. rrlc, ► .. y 4 1�t•.I+:-,etc Al �.a.. el"�JI��I _laS :lL lai�,!l:" F•i;liir �aMllit:it'�I�e� v. nrn I::Ilalc 9 �4 �IdCt•'r IS t �/ �^F Eei4! I.�.II •SC _ F 1',1S1 G ' { k 1�n� tin Lh+' etl.jc' MIAWDADE COUNTY 1 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 cm'-) — 23 (148.4 cmZ) square inch adhesive contact with the underside of the tile. •••••• Medium Profile / Double P'AA *Ziild • • • • • • • • • • 1. Starting at the eave course,M a minimum 2 (50.8 mm) x 10" (254 mrpj jF.V; (25.4 mm) foam 0 : O * • paddy onto the underlayroeilt•pdsitionedAAown • • • • • • under the pan portion of ibc-46closest to.the . • overlock of the tile beingset. 0 0 • ...:. • .••••• 2. Continue in same manner.•Ihsufe app*3x "4ely 1 • (109.7 cmZ) — 23 (148.4 cm') square intIllatlhesive 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 the closest to the overlock of the tile being set. 2. Continue in same manner. Insure approximately 17 (109.7 cmZ) — 23 (148.4 cmZ) 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 ADHESWE PLACEMENT DETAIL # 2 ^. n.I t---.I. �1• "h':-�1—' i,-hd!r rtgpirz3l f' t iva C!a�mr. M1WkDADE COUNTY ..� � 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 cmZ) — 23 (148.4 cm) 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 0 f j114 file being set. • 3. Continue in same manner. GIJT.F;pproximalely 10 • (64.5 cm) - 12 (77.4 cmZ) sgv4; inch ad1j%stye • • • • contact with the underside ofthettle. ' • • ..' •••••w •• w •ww•• Medium Profile / Double Pan.*rilf'; •, 1. Starting at the eave course,�applye minimum 2" (50L„,, mm) x 10" (254 mm) x l" (25.4 mm) foampaddy 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 cm') — 23 (148.4 cmZ) square inch adhesive contact with the underside of the rile. 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 cmZ) 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 4rld 1!� � au•.;ri plr �.. Lc,ocrd I. I QMIAMI-OADE COUNTY ..• � ADHESIVE PLACEMENT DETAIL # 2 (CONTINUED) 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 cm'-) — 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 thfppn. portion of the tile closest to t* oy&jock of the tile .... • • being set. •••��• • ,�•�•• �•�•�• 3. Continue in same manner. Ins�g*pproximiell 17" 00 . • • . (109.7 cm) - 19 (122.6 cm2) Sgyw'inch dtUWLVe ..... contact with the underside of tha We. .. . • . . • : • •' • •• •• •• • •••••IL •••••• • • • • • • •••••• NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 8 of 11 ADHESIVE PLACEMENT DETAIL ## 3 NA through plastic cement -addy'I etweentilesi Iwhenrequired:` j ► Battens optional e I Paddylundertilei angle paddy V ?� on tapcfitile Fi 5in lapaddy undertil��'� � singlepaddy �� cn underla-gmen j ---•ESVeclosure Flat?Low Profile The Nail through plastic cament Single paddyundertile (when requiredl �^•� Faddyl�etweentilest r Battens _ •'�`�•„ •. ' paddyiundertiie: optional ¢- •f r 5inglepaddr�`� j"- �: ,� "�•� `* man top u`tile. x 1` 4 d in. '� •' I l 2xAin. ' �. L Sin lepaddyoi _ <� y`'`. �-s�'> un�erlaynlent/ ``_�� r/�>a3 >.� s •.k;>,�� ,•.�•.. ij• , Ss � Eave Closure E.-Coursa+r,�:%ram-' Fascia Medium ProfileTlle MIAMFDADE COUNTY 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 rile 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 a 4" (101.6 mm) x 4" ((.,101.6 m&l V f' (25.4...... mm) foam paddy onto the tltlWayme•rAjost below the second course line pogkhf ft foam paddy • • • • • • under the strengthening Wfcf?flat tile, orLnder thg. pan portion of the rile, closest to the uva8r'lack for • • 41 06 •••• ••.•• the second course tile to ti jrj stilled. Insure • • • •. approximately 8-9 in2 (5 J k%V cm2)gZ+esive contact with the undersi&4%Ltbe tile. • J ••..•• • • • • • (Instructions continued on next pagt) • • • • • NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 9 of 11 ADHESIVE PLACEMENT DETAIL # 3 (CONTINUED) Nall through plastic Sirgle paddy under L-le {wh1n requiredl pa."Cly Ib±tw@p<i tdr-sl Bartens opiic•rtial I - •' Paddy undvrFde: _� fm Sircle 2x-1in. pad'= r Oil`+~vf''` ' ar?Coarse ' `'�_:`' ,. �Y'Fastia zEo� a -. _;'0_ ' 'Weeph,_•1? i41n. 21n J rip High ProfileTlle Also apply a 2" (50.8 mm) x 4" (101.6 mm) x (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 cm') - 11 (71 cmZ) square inch adhesive contact with the underside of the tile at the overlap and 7 (45.2 cm') - 9 (58.1 cm'-) square inch adhesive contact with the underside of the tile at the head of the tile. Continue in same manner. • • • • • • •••••• •••• • •• •• "0 • •••••• • • • • • 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. Steep pitch applications in contact with the pan tile. (when required) 2) Turn covers upside down. Place adhesive in to 1 in. from outside edge of cover tile. Then install the tile. Ensure 20 to 2S sq. in. contact area. Underlayment Sheathing i Eave closure (motar shown) Weephole Fascia Board Remove top portion of the eave 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 CM AMI-DADE COUNTY . ....• t 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 (419.4cm'�— 70 (fir 6LatnZ) • • • • • • square inch adhesive contaet4th the maderside of the pan tile. •••••• •••• •••••• • •••••• 3. Turn covers upside dowu•e4tgsing tlVtAderside • • of the tile. Apply a minimnm•'1" (25.4 d" x 10 • • : • • (254 mm) bead of adhesive directly on W inner .. .. •• • ...... edge of each side of the Fpyp; Vie. Leav % • • approximately 3/4" (19 Iun) t4 1" (2 A W) • • • • ; • from the outside edge of the tile, inwWd,*Me of foam to allow for expansion - • • • • • • 4. Turn cover tile over after foam is applied and place onto pan tile course. Insure a minimum of 20 (129 cmz) - 25 (161.3 cm') square inch contact area on each side of the cover tile to the 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) nailers 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 am MIAMFQADE MUM-DADE COUNTY PRODUCT CONTROL SECTION DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) 11805 SW 26 Street, Room 208 BOARD AND CODE ADMINISTRATION DIVISION Miami, Florida 33175-2474 T (786) 315-2590 F (786) 315-2599 NOTICE OF ACCEPTANCE (NOA) www.miamidade.gov/economy Polyglass USA Inc. 1111 W. Newport Center Drive Deerfield Beach, FL 33442 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 Cor"4 �ectio ; ..... (in Miami -Dade County) and/or the AHJ (in areas other than Miami -Dade County) reserve tt ilg4t to ha-je Jis • • product or material tested for quality assurance purposes. If this product or material fails to pezfem in tile.aaoepted ....:. manner, the manufacturer will incur the expense of such testing and the AHJ may immediate15431voke, modify, or • suspend the use of such product or material within their jurisdiction. RER reserves the right td rNoke tW9*Atgptanc8, • if it is determined by Miami -Dade County Product Control Section that this product or materiali'ails to me�t't'he "0 requirements of the applicable building code. 00 • 0.0 •000000 • • • 0 * 0 0 This product is approved as described herein and has been designed to comply with the Flo . ildin Code • P PP � P Y 17d�.Q>a g qd 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, 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 and revises NOA No.15-0410.04 and consists of pages 1 through 8. The submitted documentation was reviewed by Freddy Semino.l NOA No.: 17-0614.22 MIAMFUADE COUNTY1111111. Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 1 of 8 ROOFING COMPONENT APPROVAL Category Roofing Sub -Category: Underlayment Material: SBS , APP Self -Adhering Modified Bitumen PRODUCTS DESCRIPTION: Test Product Product Dimensions Specification Description Polystick IR-Xe 65' x 3'33/8' ASTM D 1970 A fine granular/sand top surface self -adhering, APP Manufacturing Or 65' x 3' polymer modified, fiberglass reinforced, bituminous Location #1 & #2 60 mils thick sheet material for use as an underlayment in sloped roof assemblies. Designed as an ice & rain shield. Polystick Dual Pro 61' x 3'3 3/s" TAS 103 and A rubberized asphalt self -adhering, glass-fib;r/,jUyester Manufacturing 60 mils thick ASTM D 1970 reinforced waterproofing membrand.. Designed as a " Location #2 metal roofing and roof tile underlay t. • Polystick Tile Pro 61' x 3'33/8" ... .. .... ...... TAS 103 and A rubberized asphalt self-adhetl1 j, * lass-fiber/polyestet .... ; Manufacturing 60 mils thick ASTM D 1970 reinforced waterproofing meiWran *..Desiw ZrA-a metal �' Location #2 roofing and roof tile underlaynj;it0, : : � 0 0* *0 ; 66 00 - Polystick TU Max 65'8" x 3'3-3/8" . . . . TAS 103 and A rubberized asphalt self-adhe'nn�g,'ppolyester reinforced — Manufacturing 60 mils thick ASTM D 1970 waterproofing membrane. Designedes a a j00%ile Location # 1 & #2 underlayment. •' •' •' . . . ...... Polystick TU P 32' 10" x 3'33/8" . TAS 103 and A rubberized asphalt waterproofing membiene; * )ass - Manufacturing 130 mils thick ASTM D 1970 fiber/polyester reinforced, with a granular surface Location #2 designed for use as a tile roof underlayment. Polystick TU Plus 65' x 3'33/8" TAS 103 and A rubberized asphalt self -adhering, glass-fiber/polyester (Surface Printing) 80 mils thick ASTM D 1970 reinforced waterproofing membrane. Designed as a metal Manufacturing roofing and roof tile underlayment. Location #1 & #2 Polystick MTS 658" x 3'33/8" TAS 103 A homogeneous, rubberized asphalt waterproofing Manufacturing 60 mils thick membrane, glass fiber reinforced with polyolefinic film Location #2 on the upper surface for use as an underlayment for metal roofing, roof tile, slate tiles and shingle underlayment. Polystick MTS Plus 6518" x 3133/g" TAS 103 A homogeneous, rubberized asphalt waterproofing Manufacturing 60 mils thick membrane, glass fiber reinforced with polyolefinic film Location #2 on the upper surface for use as an underlayment for metal roofing, roof tile, slate tiles and shingle underlayment. Elastoflex S6 G 32'10" x 3'3 '/8" TAS 103 and Polyester reinforced, SBS modified bitumen membrane Manufacturing ASTM D 6164 with a sanded back face and a granule top surface. For Location #2 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 EVIDENCE SUBMITTED Test Agency Test Identifier Test Name/Report Date Trinity ERD P10870.09.08-R1 TAS 103 12/04/08 P10870.04.09 TAS 103/ASTM D4798 & G155 04/13/09 P33360.06.10 ASTM D1970 07/01/10 P33370.03.11 TAS 103 03/02/11 P33370.04.11 ASTM D 1623 04/26/11 P36900.09.11 TAS 103/ASTM D4798 & G155 09/01/11 P37300.10.11 TAS 110/ASTM D4798 & D1970 10/19/11 P40390.08.12-2 ASTM D 1623 08/07/12 P37590.07.13-1 ASTM D6164 ; • •03/02/13 .... P45270.05.14 TAS 103, TAS 110 & ASTUJ51423 .."/12/14 .' P46520.10.14 ASTM D 1623 • • •: • • " • • 143/ 14....:. P44360.10.14 TAS 103 & TAS 1 ?0 .. • • t0/07/ 14:... ; P43290.10.14 ASTM D 1970 & TAS 110'. ."10417/14• • PLYG-SC 10130.06.16-3 TAS 103 & TAS l l d * * * ::86/27/ 16* . PLYG-10130.06.16-1 ASTM D1970 & TAS 1;l :• -9,,4 27/16:::::. PRI Asphalt Technologies PUSA-035-02-01 TAS 103 09/29/06 '. � �' : PUSA-055-02-02 TAS 103 • • }1f10/07: PUSA-089-02-01 TAS 103/ASTM D4798 & 0155 07/06/09; • • • • ; Momentum Technologies, Inc. JX20117A TAS 103/ASTM D4798 & G155 • •04/01/08 RX14E8A TAS 103/ASTM D4798 & G155 11/09/09 DX23138B TAS 103/ASTM D4798 & G155 02/18/10 DX23138A TAS 103/ASTM D4798 & G155 02/18/10 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. MIAMMDADE COUNTY 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. NOA No.: 17-0614.22 MIAMMDADECOUNTY Expiration Date: 09/13/21 1' ' Approval Date: 07/06/17 Page 3 of 8 INSTALLATION PROCEDURES: Deck Type 1: Wood, non -insulated Deck Description: Min. 19/32" plywood or wood plank System Type E(1): Anchor sheet mechanically fastened to deck, membrane adhered Anchor/Base Sheet: One or more plies of ASTM D 226 Type II or ASTM D 2626. Fastening: 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) Membrane: 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. Surfacing: See General Limitations Below. Deck Type 1: Wood, non -insulated • Deck Description: Min. 19/32" plywood or wood plank • • • • • • • • System Type E(2): Anchor sheet mechanically fastened to deck, membrane adhered • • • ; • • • • • • • • • • • : • Anchor/Base Sheet: One or more plies of ASTM D 226 Type H or ASTM D 2626. • • • • • • ; • • • • ; Fastening: Per FBC 1518.2 & 1518.4 Nails and tin caps 12" grid, 6" o.c. at a Milihnum Vittwl lap. (fdt; • • base sheet only) •••••• 00 0:•:: Membrane: Elastoflex S6 G, hot asphalt applied • • • • • • 0 • • Surfacing: See General Limitations Below. • • • • • • • • • • • • • • . . . 0000 . Deck Type 1: Wood, non -insulated Deck Description: Min. 19/32" plywood or wood plank System Type E(3): Base sheet mechanically fastened to deck, subsequent cap membrane self- adhered. Anchor/Base Sheet: One or more plies of ASTM D 226 Type II or ASTM D 2626. Fastening: 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) Ply Sheet: Polystick MTS Plus, self -adhered with minimum 3" horizontal laps and minimum 6" vertical laps. Membrane: Polystick TU Plus, self -adhered. Surfacing: See General Limitations Below. NOA No.: 17-0614.22 MAMFDADE COUNTY Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 4 of 8 INSTALLATION REQUIREMENTS: 1. 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. 2. Place the underlayment over metal drip edge in accordance with RAS 111. 3. 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. 4. 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. 5. For ridge applications, center the membrane and roll from the center outward in both directions. 6. Roll or broom the entire membrane surface so as to have full contact with the surface, giving special attention to lap areas. 7. Flash vent pipes, stacks, chimneys and penetrations in compliance with Roof Assembly current Pfodnd.lControl • . • . • • Notice of Acceptance. • 8. All protrusions or drains shall be initially taped with a 6" piece of underlayment. The flashing taps i:han be .... ; pressed in place and formed around the protrusion to ensure a tight fit. A second layer @tPolystick shall be applied over the underlayment. .... .... ..... ...... .. . ..... GENERAL LIMITATIONS: • .. .. .. . ...... 1. Fire classification is not part of this acceptance. • . . . . ...... 2. Polystick Dual Pro, Polystick Tile Pro, Polystick TU Plus, Polystick MTS and Palystiek MTS Vlus may bey ... used in asphaltic shingles, wood shakes and shingles, non-structural metal roofing, roof tile Systen:s gnd quarry • slate roof assemblies. 0009 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 roofing and roof tile systems. Polystick TU Max may be used in non-structural metal roofing and roof tile systems. Elastoflez 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 Da s MTS IR-Xe Elastoflez 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 MIAMFDADE COUNTY Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 5 of 8 Rule 61 G20-3 of the Florida Administrative Code. & 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 Polystick Elastoflex Polystick TU Plus, Polystick Polystick System (U) Profile MTS S6 G TU P, Tile Pro, TU Max MTS Plus MTS Plus with Dual Pro %V.111us Flat Tile Prohibited 4:12 6:12 6:12 5:PZ.' .6:12 without battens •••••• •••• •• Profiled Prohibited 4:12 6:12 6:12 4:12 • • • • & 12 ; • Tile without battens • • • • • • • • • 10. The above slope limitations can be exceeded only by using battens in accordance witltdrA;pprovgd-Ti % System... Notice of Acceptance and applicable Florida Building Code requirements. When battlrhs`fe requir ti, they sha11 •; • be utilized during loading and installation of tiles. • • • • • • . . . . ..... . Care should be taken during the loading procedure to keep foot traffic to a minimum and to avoid dropping of • tile directly on the underlayment. Refer to Polyglass' Tile loading detail below for loading procedure, •-Vo tiles • laid perpendicular to slope followed by a maximum four tile stack parallel to the slope, for a total of'Gtiles — for all underlayments except Polystick MTS which shall be loaded onto battens. ,&&is POLIMCKTU Plus 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' j�PPLIUATIONS. •' • • • • • LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND RECOMNYNDATION9 * ` `. ' • • 1. Polyglass does accept the direct application of Polystick underlayment membranes to w9gd decks. I1;Stglers arJ • • • • cautioned to refer to applicable local building codes prior to direct deck installation to busgathis is" arrml table...... Please also refer to applicable Product Data Sheets of the corresponding products. • • • • • • 400*00 • • • • • 2. All rolls, with the exception of Polystick TU Plus should be back -nailed in selvage ed � . • • as er P 1 lass , • • • P Y g �� P 4 Yg .' Back Nailing Guide. Nails shall be, 11 gauge ring shank type, applied with a minimurd I %"�netal,diskas ....;f required in Miami -Dade County or simplex type nail as otherwise allowable in other redone, at a minimum rate. • of 12" o.c. Polystick TU Plus should be back nailed in designated area marked "nail arM area parq cam" on : * * • the face of membrane, with the above stated nails and/or disks. The head lap membrane is to cover tits 9f ea 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 TV12" or greater. It is suggested that on pitch/slopes in excess of 6'/4"/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. 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 codesprior 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 SPPiCIFJC APPUICATIONS. • • • • • • • •. •. LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND RECOMIE MIATIOW END OF THIS ACCEPTANCE :::::o 0000 .... .... ..... ...... ..... ....00000,..0...... . . . . . ...... . ...... .. . . .. . .. . NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 8 of 8 February 6, 2020 To: Miami Shores Village Building Department 10050 NE 2"d Avenue Miami Shores, FL 33138 Engineering & Testing Co. 7450 Griffin Road, Suite 140, Davie, FL33314 Phone: (954)581-7115, Fax: (954)581-2415 www.cebb.net Roof Tile Unlifl Test Renort Test Date: February 6, 2020 Permit #: RF-10-19-2365 Address: Peragallo Residence 55 NE 97 Street, Miami Shores, FL Contractor: Statewide Roofing, Roof Pitch: 5:12 Attachment method: Adhesive Pol set AH-160 Tile Type: Boral Plantation Device Used: 441MADA DPS 1 10" force gauge (Serial # 340509) Total Sloped Roof Area: 6.00 squares All 'Testing is in strict accordance with the Florida Building Code, 2017 Edition, High Velocity Hurricane Zone — Testing Application Standard (TAS) 106. Roof Area: 6.00 squares Total Number of Tests Number of tests Passed % Passed Field Area (1): 2.00 squares 6 (T 16-T21) 6 (TI O- f 15) 8 (1-1-T8) 1 ('1.9-1-9) 6 6 8 1 100% 100% 100% 100% Perimeter Area 2 : 4.00 squares No. of Corner Areas 3 : 8 Ridge/Hip Areas: 15 pcs Based upon the field tests, I certify that 100% of the static up -lift tests "PASSED" the testing, criteria of 35.0 lbf load, and meets the attachment resistance for adhesive Set Systems, as specified in the NOA. Should you have any questions regarding the above. or if require additional information, please do not hesitate to contact this office. Sincerely, CeBB Fngincering & Testing Co (NOA 1 ! 12-9.01) 02/06/20O..I, _ Eduard radiu, PY. Fla. Reg. No: 59997 For The Firm Cc: Statewide Roofing Rooting Inc. Location Sketch Calibration Certificate 1 Em Engineering & Testing Co. 7450 Griffin Road, Suite 140, Davie, FL33314 Phone: (954)581-7115, Fax: (954)581-2415 www.cebb.net HANDLIFT RESULTS: Passed the protocol criteria of less than 3% loose. We erformed the up -lift test. Roof Area: 6.00 squares Total Number of Tests Number of tests Passed % Passed Field Area 1 : 2.00 squares 6 (T] 6- I'21) 6 (T10-T15) 8 (T1-"1-8) 1 (T9-T9) 6 6 8 1 100% 100% 100% 100% Perimeter Area (2): 4.00 squares No. of Corner Areas (3): 8 Ridge/Hip Areas: 15 pes -: - ti 00' 3 C` TAS 106 TESTS LOCATION SKETCH Permit # RF-10-19-2365 Peragallo Residence 55 NE 97 Street. .7 v �M: 1 1 1 Engineering & Testing Co. 7450 Griffin Road, Suite 140, Davie, FL33314 Phone: (954)581-7115, Fax: (954)581-2415 www.cebb.net Miami Shores. FL TEST RESULTS (P = PASSED. F = FAILED) Test Location Uplift Pull Test (13 or F) Test Location Uplift Pull Test (13 or F) Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or F) Test Location Uplift Pull Test (P or 1 P 2 I' 3 P 4 P 5 P 6 P 7 P 8 P 9 P 10 P 11 P 12 P 13 P 14 P 15 P 16 P 17 P 18 P 19 P 20 P 21 I' I. 1 a 1 Engineering & Testing Co. 7450 Griffin Road, Suite 140, Davie, FL33314 Phone: (954)581-7115, Fax: (954)581-2415 www.cebb.net QC Metallurgical, hic. Testing & Consulting Servius CFBB Corporation P.O. No. Verbal Imada-Force Gauge Rim6c0.110Lbs. Accuracy ±I%(',aIndicated Scale Serial No. 340509 Standard In Lbs. Instrument Reads in Lbs 0 0 10 C 10.0 20 C 20.0 40 C 40.0 60 C 60.0 80 C 80.0 100 C 100.0 20 T .20.0 40 T -39.9 60 T -59.7 80 T -79.6 100 T -99.3 Force Gauge is within ;1 % of indicated scale. June 18, 2019 QCM Job No I9fM475 CalibrmedaithMmmTenuleMa&u.1,WCell "W.0CM-a14.2plat Range0.10MLb's AocwKy a f 10% N 1 s.T a Cat 1RP1003200009. Drx 91121201a .9111120l9 Cal Nval 1 A W ANSINCSL 7-54M The accuracy and calibration of this instrument are traceable to the National Institute of Standards & Technolog and are guaranteed to meet published specifications. Date Calibrated 61192019 �'"L" '�%` 4 Date Due 6/182020 Kevin Grate Q. C. Metallurgical, Inc. V I S:Irlm; Road' Il:llr\.00d, 11. 33CM-I149 * (254) 889-I'M' fax M141 UP-114? L-man (elate a.,lcr,Ict nnu