RF-12-22-3082 INSPECTION AFFIDAVITMiami Shores Village - BUILDING DEPARTMENT
10050 NE 2 Ave Miami Shores, FL 33138
305-795-2204 wwyv.msvfl._qov
Permit# (Z4:- i2-"ZZ- 3O9Z DATE: Lk" W-ZO23
INSPECTION AFFIDAVIT
I �OS VE Vc— L y • licensed as a(n) Contractor / Engineer / Architect,
(Print name and circle License Type)
License #: CCC D� S
On or about 0'f - 03 - 20 23 t2:oo Psi I did personally inspect the roof deck nailing
(Date & time)
workat (259 Ne�- tos �-cr �� `4-•(!� S# yr s.- �- 33I
(Complete Job Site Address)
Based upon that examination I have determined the installation was done according to the
Hurricane Mitigation RWofit Manual (Based on 553.844 F.S)
State of Florida, Miami Dade County:
The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for
the above property mentioned.
Sworn to and subscribed before me this
day ofP�1�.7�
Notary Public, State of Florida at Large JAEPlNj
c� a CAALO$ A JR;1�A
t���k: Ncur: Public - State e: F,oride
"�� Cammissior. = GG 329363
'' my Comm. =x,ires 1ui 3 a , 2423
ac�.ced mm:gh xtjW.aI Notary Assn.
For Forms and Applications click here:
http://bldg.miamishoresvillage.com/WebLink/Browse.aspx?id=118080&dbid=0&repo=Mia
miShoresVillage
to
Rev01142021 Inspection Affidavit Page 1 of 1
Lab Report No. 13S898R
FLORIDA � TEC
PROVIDING SOLUTIONS TO THE ROOFING INDUSTRY
CONCENTRATED UPLIFT LOAD TESTING ON ROOF TILE
TO COMPLY WITH FBC PROTOCOL TAS-106
PROPERTYADDRESS: 145 NE 98"' Street, Miami Shores
PROPERTY OWNER:
CONTRACTOR: Oroni Inc
TILE TYPE: Spanish "S
ATT.ACHMENTMETHOD: Foam Adhesive
Testinq Equipment: Uplift Gauge FGE-10OX Test Tabulation
C.A. # 30448
Lab Certificate # 22-0412.01
PERIIIIITNo:
RF-03230538
ROOFING SQUARES:
14
ROOF PITCH:
5:12
INSPECTOR INITIALS:
AA
TEST DATE:
05/01/2023
Required Testing
Force: 35 lbs
No.
RESULT
No.
RESULT
No.
RESULT
No.
RESULT
No.
RESULT
1-9
Passed
10-19
Passed
20-26
Passed
THIS ROOF HAS PASSED THE STATIC UPLIFT IN ACCORDANCE WITH FBC PROTOCOL TAS-106.
"ROOF SKETCH"
67
Sincerely,
Yan L. Solis, P.E.
The method and sof ware that have
Lic. No. 75423
been utilized to sign and seal the
Digitally signed
Yan L u i s by Yan Luis Solis
report, comply with the intent of the
Board Rules. Specifically, with
Date: 2023.05.02
reference to Florida Statutes 471 and
Solis
14.49:08-04'00'
the Florida Administrative Code Rule
61G15-23.003for Engineers.
12274 SW 131" Avenue
Miami, FL 33186
Page 1 of 1
www.FloridaTEC.net
IPltltr
so��'f.
* • No. 75423 "*
STATE OF
ORIDP'••"
Tel: 305-256-4550
Fax: 305-256-6833