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RF-12-19-2988, 100 NE 101st StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number Permit Status:ppruw /06/207-0 Expiration:07/06/2020 00 NE 101ST ST, Miami Shores, FIL 33138 1132060132020 .>.�c.'...w:.:ae:..�as�o.�'�e�o�..,.,��C;e�.,.�,�,..,,. Contacts BRYON THOMAS Owner SUNCOAST BUILDERS & ROOFERS Contractor 136 NE 101 ST, MIAMI SHORES, FL 331382321 LUIS SALINAS 6519 SW 21 ST, MIRAMAR, FL 33023 Business: 3054369294 Other:7865416819 Description: RE -ROOF TILE (FLAT TILE) Valuation: $ 34,000.00 Inspection Requests: 305-762-4949' Total Sq Feet: 3,566.00 Fees Amount Application Fee - Other $50.00 CCF $20.40 DBPR Fee $4.88 DCA Fee $3.25 Education Surcharge $6.80 Roofing Fee $275.00 Scanning Fee $9.00 Technology Fee $8.13 Total: $377.46 Building Department Copy Payments Date Paid Amt Paid Total Fees $377.46 Cash 01/06/2020 $377.46 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, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing informatio accurate d that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authoriKe the ove ed ontra or t the orlys)ate j.7 Authorized Signature: Owner / Applicant / Contr6ctor // Ager+f Date January 06, 2020 Page 2 of 2 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 BUILDING PERMIT APPLICATION ❑BUILDING ❑ ELECTRIC ROOFING ENTERED DEC 2 g BY: !e 20 i-1 Master Permit No. b C I I- I I` Z b� Z. Sub Permit No. -I Lfj -z q )(V ❑ REVISION ❑ EXTENSION ❑ RENEWAL ❑PLUMBING ❑ MECHANICAL [—]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 100 N 9- 1 (7 I S I City: Miami Shores County: Miami Dade Zia: 3 3 13 A Folio/Parcel#:_f_I_-32 D 6 "f 13 — 2 ®2® Is the Building Historically Designated: Yes NO Occupancy Type: 01-oad: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Q r- I M 0.TPhone#: 3 OS ` b 3 e Address: 1 O L N ®p `3 City: 1M) C?P hft 1=5 L o r e. 5 State: Zip: Tenant/Lessee Name: Email: a ,) Ir�-s CONTRACTOR: Company Name: S V /\ C JCS (A l➢ 1 L A e6 oL nd Phone#: l oS 3 OSA35 7 Address: G .5 / c S W ?j SE City: M 1 `AyrY\ Q`r State: Zip: 33 ® 2 Qualifier Name: L L)I S iF) o S CL I i n Phone#: 0_S) 305 83-5 % State Certification or Registration M C CC I 2 % �{ Certificate of Competency M DESIGNER: Architect/Engineer: Add City: State: / Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: ��, 4 Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: h D (A O () �-- Specify color of color thru tile: VJ h k T-e. Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Technology Fee $ Training/Education Fee $ Structural Reviews $ DBPR $ Notary $ Double Fee $ Bond $ ICJ Mac r TOTAL FEE NOW DUE $ "' G; (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City Mortgage Lenders Name (if Mortgage Lenders Address City 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 certiTted 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 instrumentwasacknowledged before me this QO day o++f�� ICJ C-A'I1j M. 20 � � , by IWONJhl� who is rsonafly k n to me or 1ho has produced f- as The ttoregoing instrument was acknowledged before me this -LPAO' day of /2.20 by who is personally known to me or who has produced k!5t-- V�&yg as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC Sign Print- = n; Zoning Structural Review Clerk (RevisedO2/24/2014) 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: ?o / 10050 NE 2nd Ave Miami Shores, A 33138 Re: Owner's Name: B R VON 3 o 1+Q TH O Property Address: 1 0'0 N E 1 01 5-r ,54 g ,,S FL 3 3) � Roofing Permit Number: Dear Building Official: 118A V D n 1 0H N +� O M 6}S certify that I am not required to retrofit the roof to wall connections of my building because: XThe just valuation for the structure for purpose of ad valorem taxation is less than $300,000.00. Please attach proof of ad 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) Signature State of Florida County of Dade TO A rint Name The undersigned, being the first duly swom, deposes and says that he/she is t��� >°o bove roe mentioned. n,�,,,� property rtY Sworn to and subscribed before me this `�� J�U ''caYIf �� :F� °,°y •° �' tuy f "p C9LbS6 :�� • r Notary Public, Sate of Florida at Large o f. v r� m • When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than $300,(iQ� Qggq �a i�°�vas not constructed with FBC nor a 1994 SFBC. Then you must provide a building application from a General Contractor for the Roof to Wall connection Hfu ai le " ination. Revised on 512IJ2009 Address Owner Name Folio SEARCH: 100 ne 101 st Q PROPERTY INFORMATION Folio: 11-3206-013-2020 Sub -Division: MIAMI SHORES SEC 1 AMD Property Address 100 NE 101 ST Owner BRYON JOHN THOMAS ALEJANDRA JOHNSON THOMAS Mailing Address 100NE101ST MIAMI SHORES, FL 33138 PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL -SINGLE FAMILY: 1 UNIT Beds / Baths / Half 2/2/0 Floors 1 Living Units 1 Actual Area Living Area Owner BRYON JOHN THOMAS ALEJANDRA JOHNSON THOMAS Mailing Address 100 NE 101 ST MIAMI SHORES, FL 33138 USA PA Primary Zone 1000 SGL FAMILY - 2101-2300 SQ Primary Land Use 0101 RESIDENTIAL - SINGLE FAMILY: 1 UNIT Beds / Baths / Half 2/2/0 Floors 1 Living Units 1 Actual Area Sq.Ft Living Area Sq.Ft Adjusted Area 2,936 Sq.Ft Lot Size 12,149.75 Sq.Ft Year Built Multiple (See Building Info.) Featured Online Tools Comparable Sales Property Record Cards Report Discrepancies Tax Comparison Value Adjustment Board ASSESSMENT INFORMATION Hide Legend(s) Visible legend Show Legend(s) Glossary Property Search Help Report Homestead Fraud Tax Estimator PAAdditional Online Tools Property Taxes Special Taxing Districts and Other Non -Ad valorem Assessments TRIM Notice Year 2019 2018 2017 Land Value $364,639 $303.865 $303,865 Building Value $204,346 $204,346 $204,346 Extra Feature Value $2,696 $2,712 $2,727 Market Value $571,681 $510,923 $510,938 Assessed Value $571,681 $383,356 $375,472 TAXABLE VALUE INFORMATION 2019 2018 2017 COUNTY Exemption Value $0 Taxable Value $571,681 SCHOOLBOARD Exemption Value $0 Taxable Value $571,681 CITY Exemption Value $0 Taxable Value $571,681 REGIONAL Exemption Value $0 Taxable Value $571,681 BENEFITS INFORMATION Benefit Type 2019 Save Our Homes Cap Assessment Reduction Homestead Exemption Second Homestead Exemption Civilian Disability Exemption Note: Not all benefits are applicable to all Taxable Values (i.e. County, School Board, City, Regional). FULL LEGAL DESCRIPTION MIAMI SHORES SEC 1 AMD PB 10-70 LOTS 13 & 14 BLK 15 LOT SIZE IRREGULAR OR 20710-1074 09 2002 1 SALES INFORMATION $50,500 $50,500 $332,856 $324,972 $25,500 $25,500 $357,856 $349,972 $50,500 $50,500 $332,856 $324,972 $50,500 $50,500 $332,856 $324,972 2018 2017 $127,567 $135,466 $25,000 $25,000 $25,000 $25,000 $500 $500 Previous Sale Price OR Book -Page Qualification Description Previous Owner 1 Previous Owner 2 09/07/2018 $650,000 311364130 Qual by exam of deed SERGIO C PEREZ 09/01/2002 $380,000 20710-1074 Sales which are qualified 02/01/2000 $270,000 19018-4109 Sales which are qualified 11/01/1994 $143,000 16631-0140 Sales which are qualified For more information about the Department of Revenue's Sales Qualification Codes. 2019 2018 2017 LAND INFORMATION Local Business Tax Receipt Miami —Dade County, State of Florida THIS IS NOT A BILL - DO NOT PAY 6331151 RECEIPT NO. RENEWAL BUSINESS NAME/LOCATWm-6597802 SUNCOAST BUILDERS & ROOFERS INC DOING BUS IN DADE CO MIAMI, FL 33000 EXPIRES SEPTEMBER 30, 2020 Must be displayed at place of business Pursuant to County Code Chapter SA - Art. 9 & 10 OWNER SEC. TYPE OF BUSINESS SUNCOAST BUILDERS & ROOFERS 196 SPECIALTY BUILDING INC CONTRACTOR Worker(s) CCC1327854 PAYMENT RECEIVED BY TAX COLLECTOR 75.00 09R52019 0204-19-007685 This Local Bashiew Tax Rseelpt only oodirms payment of the local Bmlmn Tan. The Recalpt to ad a a-mne, VVIVIL ar a.aertilb aUon of the habbu's qu llficadom to do baslam Holder mm comply with ear gavel ar 0wQw"MM8nW rag dMq laws and regalremems which only to the badeass. The RECEIPT NB. above mast be ftPlayed an ell commmvial wddcla - Miw -Dada lade Sea 8a-m For more ia(ormation, visit Ronuff ROOF ASSEA 11 SS ANb W6O�"fF iS L URES 4 A N Florida Bu g C e 52h T can ( 14)High-Velocity Hurricane Zone Un orm Pmit Application! Form; Section A (General Information) 1 Master Permit No. Process No. 1 Contractor's Name U nco CS* U I Q(:5.' CLR A' 1 Job Address 1 0 O( 1 C�.+n t 1 ROOF CATEGORY /Mortar/Adhesive ❑ Low Slope ❑ Mechanically Fastened Tile Set Tiles 1 ❑ Asphaltic Shingles ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes 1 1 ❑ Prescriptive BUR-RAS 150 1 ROOF TYPE • • ❑ New roof ❑ Repair ❑ Maintenance Reroofing • • 0 • Q Re;ver.n@ �: ROOF SYSTEM INFORMATION ` 000000 : • • • • • • �� • Low Slope Roof Area (SF) ® Steep Sloped Roof AREA (SSF), S b Total (SF) • 5• 0 66 • : • • i • Section B (Roof Plan) • • • • • • •"' •"�' Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers • • • • • • • • • sions of sections and levels, clearly identify dimensions of elevated pressure zones and locatiandooveerfiow drains, Inqude dlmen- `• sa bats. ...d:. • • ••• •• 1 1 1 1 1 1 1 1 � 1 1 1 1 1 1 1 1 FLORIDA BUILDING CODE — BUILDING, 6th EDITION (2014) 15.37 I Ill 1 1 / 1 I 1 ° CoPYriBbt to, or licensed by, ICC (ALL RIGHTS RESERVED); accessed by Eliezer palacio on Jun 8, 2015 10:32:12 AM pursuant to uccnse Agreement. No further reproductions authorized. ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code 5th Edition (2014) High -Velocity Hurricane Zone Uniform Permit Application Form Section D (Steep Sloped Roof System) Roof System Manufacturer. 80 4-CA,I `` LOG f- j Notice of Acceptance Number. I q .- O A 14. 0 1 9 Minimum Design Wind Pressures, ff Applicable (From RAS 127 or Calculations): P1: - A' . (n pl. - 0 6, (0 Pq� — D 0 s Deck Type: e r 1 Roof Slope: Type Underlayment 1 —�— 12 Insulation: 1 Fire Barrier: Lee:* so 0;*000: Ridge Ventlati ? Fastener Type & Spacing: C i' '.. iA FI � S ��i�•ee Pam, Adhesive Type: S e L C( t� ZtS �li� • Type Cap Sheet oil •' 0L�. �� �••••: 1 Mean Roof Height: �, Roof Covering: 5040in 00 Cone re 0 7r l 1 Type & Size Drip 1 Edge: -3x3 qlvctn 1 1 FLORIDA BUILDING CODE — BUILDING, 5th EDITION (2014) 15,89 1 1 1iN. ����t BQ by m+0 00 Jung. 2015 103212 AM pursuant to licrnse e 1 1 1 1 1 1 i 1 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Sth Edition (2014) High -Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based file systems, choose either Method 1 or 2. Compare the values for M, with the values from K. If the Mt values are greater than or equal to the M, values, for each area of the roof, then the the attachment method is acceptable. Method 1 "Moment Based Tile Calculations Per RAS 127" Product Approval M, /.3 Mg: I—SO(Z Ma q ■■112Product Approval M, (P3: Ion• 1 0. 315='3 �.(7� Mg: 14V-- M.2+1 SRnoduct Approval M, Method 2 "Simplified Tile Calculations Per Table Below" Required Moment of Resistance (M.) From Table Below � 2-2 PM6 int Annmval ne -3 , _ A M, required Moment Resistance' Mean Roof Height Roof Slope 15' 20' 25' 30' 40Y 2:12 34.4 36.5 382 39.7 42.2 3:12 322 34.4 36.0 37.4 .. 39.8 4:12 30.4 322 33.8 35.1 • 3 5:12 6:12 28.4 26.4 30.1 28.0 31.6 29.4 32.8 30.5 �4.9 ... 4 7:12 24.1 25.9 27.1 28.2 000300.0 ..•. 'Must be used in conjunction with a list of moment based tile systems endorsed by the Broward CounV 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�valuep are grO't�r'4Rs�'n or equal to the Fr values, for each area of the roof, then the tile attachment method is acceptable. : • Method 3 "Uplift Based Tile Calculations Per RAS 127" (P1:_ x L _ _ _ x w: _ _� — W. x cos 0 _ = F„ Product Approval F (P2:_ x L _ = — x w: _ — W: x cos 6 _ = F,2 Product Approval F (P3:_ x L _ = x w: _ _� — W: x cos 0 _ = FA Product Approval F Where to Obtain Information Description Symbol Where to find Design Pressure P1 or P2 or P3 n ines� analysis pre - Pa S 1by pE basedor b an engineering Mean Roof Height H Job Site Roof Slope A Job Site Aerodynamic Multiplier X Product Approval Restoring Moment due to Gravity Ma Product Approval Attachment Resistance Mr Product Approval Required Moment Resistance M. Calculated Minimum Attachment Resistance F Product Approval Required Uplift Resistance F Calculated Average Tile Weight W Product Approval The Dimensions L = length W = width Product Approval All calculations must be submitted to the building official at the time of permit application. 15.40 FLORIDA BUILDING CODE — BUILDING, Sth EDITION (2014) 1 I 1 1 1 Copytt M to. or licen5ed by. ICC (ALL RIGHTS RESERVED): accessed by 1'lk= Palaeio an Im S. 2015 1031-12 AM to license A�mt No Sather reFoductims mahmiad. 1 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. The owner's initial in the designated space indicates that the item has been explained. 2• .B.Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior to removing the existing roof system). • 4• Exposed Ceiling: Exposed, open beam ceilings are where the un%146e of the goo{decking , •' • can be viewed from below. The owner may wish to maintain the architectural ap'eare rice; thgrpforp, ;... •; roofing nail penetration of the underside of the decking may not be accept, erovides:hd ppfion of ..... maintaining the appearance. • ...... .... ..... .. .. .... ...... 6. _Overflow scuppers (wall outlets): It is required that rainwater flows off A that the redf is """ not overloaded from a buildup of water. Perimeter/edge wall or other roof extengion play blocR this : • • • • discharge if overflow scuppers (wall outlets) are not provided. It may be necessa?no install overfir • scuppers in accordance with the requirements of Sections R4402, R4403 and R4413. 1 wnee)Agents Signature Date Co actor Signature Date I00 N G ) 0 51 yi 1 ck/kb 5%0,ss R L -''I —I 1 — 2 V � L Property Address FL, 3 3 ) � O Permit Number Revised on 7/9/2009 LD;07/01/2015; MIAMFDADE MIAMI-DADE COUNTY PRODUCT CONTROL SECTION DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) 11805 SW 26 Street, Room 208 BOARD AND CODE ADMINISTRATION DIVISION Miami, Florida 33175-2474 T (786) 315-2590 F (786) 315-2599 NOTICE OF ACCEPTANCE (NOA) www.miamidade.eov/economN Boral Roofing, LLC 7575 Irvine Center Drive, Suite 100 Irvine, CA 92618 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 hpyjA{ product or material tested for quality assurance purposes. If this product or material fails to perf" in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediatelyPreJoke, do -di por suspend the use of such product or material within their jurisdiction. RER reserves the right N sevoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or mater1'a*1 *f6#i1s to meet tjie requirements of the applicable building code. ' ' ' .... . .. ..... This product is approved as described herein, and has been designed to comply with the FloridaeRxildin$ er"k0 • •"• • including the High Velocity Hurricane Zone of the Florida Building Code. • • • • • •" ...... 00 DESCRIPTION: Saxony 900 Concrete Roof Tile •� ;"'" .a LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and'fiill'owing 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.19-0408.01 and consists of pages 1 through 9. The submitted documentation was reviewed by Freddy Semino a NOA No.: 19-0814.01 0-n�oE eouNW Expiration Date: 04/26/22 Approval Date: 11/27/19 Page 1 of 9 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub-Cateeom Roofing Tiles Material: Concrete Deck Type: 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 Dimensions Saxony 900-Slate Length = 17" Width = 13" thickness = 1-5/32" Saxony 900 - Length = 17" Split Shake Width = 13" thickness = 1-9/32" Saxony 900-Shake Length = 17" Width = 13" thickness = 1-9/32" Trim Pieces Length: varies Width: varies varying thickness 2.1 MANUFACTURING LOCATION 2.1.1 Lake Wales, FL Test Product Specifications Description TAS 112 Flat profile, interlocking, i essurt! extruded concrete roof tile with two Anil 1lbles. FU direct deck •. & O batten, mortar set or adhes118 ccf applications. • • G O TAS 112 •..•.• Flat profile, interlocking, highpressura ax. tm ed • concrete roof tile with two aM boles. For tltrect detlt'.' `. batten, mortar set or adhesf04 S8Cappliaat%risk Top • surface produced with 4 different configurations: • 1. Complete tile brufed• ; ....:. 2. Right half brushed.(shoy n in 11*4g) 3. Left half brushed ' .. • • • 4. No brush 0000 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.: 19-0814.01 Expiration Date: 04/26/22 Approval Date: 11/27/19 Page 2 of 9 2.2 EVIDENCE SUBMITTED: Test Agency The Center for Applied Engineering, Inc. Redland Technologies Atlanta Testing & Engineering, Inc. Celotex Corporation Testing Service Walker Engineering, Inc. American Test Lab of South Florida PRI Construction Material APPROVED Test Identifier 94-084 94-060A 25-7183-6 25-7183-5 25-7214-1 25-7214-5 Project No. 307025 Test #MDC-77 7161-03 Appendix H & IH Letter Dated Aug. 1, 1994 P0631-01 P0402 R 1.894/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 COPO-002-02-12 COPO-002-02-06 COPO-002-02-05 BORR-022-02-01 BORR-022-02-02 BORR-022-02-03 BORR-022-02-04 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 March, 1995 Oct. 1994 bec:T991 .•.••• 'Aug' 1994 • • "" . y.0994 • 'S.43t.1993 ...... !AuA.' T 994 . .. �Dte'1998 March 1999 February 1996 April 1996 December 1996 March 1995 09/01/16 April 1999 09/01/16 06/29/ 16 TAS 101 10/12/2016 TAS 101 10/12/2016 TAS 101 10/12/2016 TAS 101 02/25/2019 TAS 101 02/25/2019 TAS 101 02/25/2019 TAS 101 02/28/2019 NOA No.: 19-0814.01 Expiration Date: 04/26/22 Approval Date: 11/27/19 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 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 Mechanically attached tiles minimum slope 4/12. 3.6 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.7 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with the applicable Building Code. . sees.. e .e.e.. 4. INSTALLATION sees.. . .. sees.. sees.. 4.1 Saxony 900 (Slate, Shake & Split Shake) Concrete Roof Tile and its componenis•shall be installed in stVcl0 •: compliance with Roofing Application Standard RAS 118, RAS 119, and RAS 120! • 6 6000 06696 4.2 Data For Attachment Calculations ." .e .e sees sees.. Table 1: Average Weight (W) and Dimensions (I x w • • • ; • Tile Profile Weight-W (lbf) Length-1 (ft) : .'. Width-w (ft) :sees: . . .. Saxony 900 10.9 1.417 •'k08 Slate, Shake & Split Shake Table 2: Aerodynamic Multipliers - X (ft3) Tile ;L (ft3) ?L (ft3) Profile Batten Application Direct Deck Application Saxony 900 0.291 0.315 Slate, Shake & Split Shake Table 3: Restoring Moments due to Gravity - M9 (ft-lbf) Tile Profile 2":12" 3":12" 4":12" 5":12" 6":12" 7":12" or greater Saxony 900 Slate &, Shake & Direct Deck Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Split Shake 7.70 7.62 6.61 7.50 6.48 7.34 6.31 7.16 6.13 6.95 NOA No.: 19-0814.01 Expiration Date: 04/26/22 Approval Date: 11/27/19 Page 4 of 9 Table 4: Attachment Resistance Expressed as a Moment - Mf (ft-lbf) for Mechanically Fastened Systems Tile Fastener Type Direct Deck Direct Deck Battens Profile (min 15/32" (min. 19132" plywood) plywood) Saxony 900 2-10d Ring Shank Nails 30.9 38.1 17.2 Slate, Shake & 1-10d Smooth or Screw Shank Nail 7.3 9.8 4.9 Split Shake 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 24.3 24.3 24.2 Clip) 1-10d Smooth or Screw Shank Nail (Eave 19.0 19.0 22.1 Clip) 2-10d Smooth or Screw Shank Nails (Field 35.5 35.5 34.8 Clip) 2-10d Smooth or Screw Shank Nails (Eave 31.9 31.9 32.2 Table 5: Attachment Resistance Expressed as a Moment Mf tft' 1bf) :.. for Two Paddy Adhesive Set Systems • • • .... . .. ... Tile Tile Application Mtofgum 4tattmenth•• Profile, " "Resisthht'b Saxony 900 Adhesive' : 31.3.2 a 3• • • • Slate, Shake & Split Shake •• . . •• 59 a. • Sol • 1 See foam adhesive manufacturer's component approval for installation requirements. 2 The Dow Chemical Company TileBond- one -component foam minimum weight per paddy 13.9 grams. 3. ICP Adhesives Polyset® AH-160 two -component foam, minimum weight per paddy 8 grams. 4. DAP Products Touch N' Seal Storm Bond 2 two -component foam minimum weight per paddy 8 grams. NOA No.: 19-0814.01 Expiration Date: 04/26/22 Approval Date: 11/27/19 Page 5 of 9 Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-lbf) 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 1193 115 4 835 606 DAP Products Touch N' Seal Storm Bond 2 two -component foam 93 7 4511 3 Large paddy placement of 45 grams of Polyset® AH-160. 4 Large paddy placement of 34 grams of Pol set® AH-160 5 Medium paddy placement of 24 grams of Polyset@ AH-160. 6 Medium paddy placement of 18 grams of Polyset@ AH-160. 7 Large paddy DAP Products Touch N' Seal Storm Bond 2 two -component foam minimum weight per paddy 45 grams. 8 Medium paddy DAP Products Touch N' Seal Storm Bond 2 two -component foam minimum weight per paddy 24 grams. ...... . .. ....% Table 7: Attachment Resistance Expressed as a Moment - Mf t t -1bf) 0 • • • •; • for Mortar Set Systems ... 00 os os Goes .. .. .... .... Tile Tile Migiwpirp Attachment e Profile Application ReSista ftV,: • • • • e Saxony 900 Mortar Seth ' e e G :43.9 ., e Slate, Shake & Split Shake G G 9 Tile -rite Roof Tile Mortar 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". 4 = _ LABEL FOR BORAL SAXONY 900 TILES (LAKE WALES FL PLANT) LOCATED UNDERNEATH TILE NOA No.: 19-0814.01 Expiration Date: 04/26/22 Approval Date: 11/27/19 Page 6 of 9 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 building code in order to properly evaluate the installation of this system. NAIL HOLES PROFILE DRAWINGS UNDERLOCK SAXONY 900 - SLATE �5/j1" 0 : (Slate) : ...... ...... COUERLOCK 9690 NOA No.: 19-0814.01 Expiration Date: 04/26/22 Approval Date: 11/27/19 Page 7 of 9 PROFILE DRAWINGS NAIL HOLES 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 1-9/32" (Shake) ...... NOA No.: 19-0814.01 Expiration Date: 04/26/22 Approval Date: 11/27/19 Page 8 of 9 NAIL HOLES rN PROFILE DRAWINGS SAXONY 900- SHAKE END OF THIS ACCEPTANCE �.9/32" (Shake) •....• s • • o •• • • •• • • • ••• NOA No.: 19-0814.01 Expiration Date: 04/26/22 Approval Date: 11/27/19 Page 9 of 9 MIAMWADE MIAMI-DADE COUNTY PRODUCT CONTROL SECTION DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) 11805 SW 26 Street, Room 208 BOARD AND CODE ADMINISTRATION DIVISION Miami, Florida 33175-2474 T (786) 315-2590 F (786) 315-2599 NOTICE OF ACCEPTANCE (NOA) 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 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 t%rd #gC%pted .ee*:@ manner, the manufacturer will incur the expense of such testing and the AHJ may immediat$ly teloke, odif�, or , suspend the use of such product or material within their jurisdiction. RER reserves the right*o revoke t. s• ��ceptancei • if it is determined by Miami -Dade County Product Control Section that this product or mat�%l;Wls to meet the • requirements of the applicable building code. ,,,, ., , : "": This product is approved as described herein, and has been designed to comply with the Florida l uilding (f",,,++ including the High Velocity Hurricane Zone of the Florida Building Code. • • • ^ • • ease 69600 so of 00*0 660666 DESCRIPTION: Polyglass Polystick Underlayments . . . . ...... LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo%io, State a$d fpuowing:'•'•: 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. U NOA No.: 17-0614.22 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 3'33/8" TAS 103 and A rubberized asphalt self -adhering, glass-fiber/polyester Manufacturing 60 mils thick ASTM D 1970 reinforced waterproofing membrane. Designeda s a Location #2 metal roofing and roof tile underlayment. ; " • • • Polystick Tile Pro 61' x 3'33/8" TAS 103 and A rubberized asphalt self-adhg gg•glass-'berltelyeste �• Manufacturing 60 mils thick 000 ASTM D 1970 reinforced waterproofing meralisaw. Designed as a metal Location #2 roofing and roof tile underlaypwntr .. 0 a 0 • • • • • • Polystick TU Max 65'8" x 3'3-3/8" TAS 103 and A rubberized asphalt self-adhe� V • • of est ; • forced• *. Manufacturing 60 mils thick ASTM D 1970 waterproofing membrane. Designed as a $ sao$ file : : • • : • Location #1 & #2 underlayment. ; • •; •; ' • Polystick TU P 32'10" x 3'33/8" TAS 103 and A rubberized asphalt waterproofr�mem13?ah*'glass-• Manufacturing 130 mils thick ASTM D 1970 fiber/polyester reinforced, with *a gmnulapsupfa�e :"'•; 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 NITS 65'8" 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 NITS Plus 6508" x 313/8" 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. Elastoflez S6 G 32'10" x 33 %" 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 I 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 07/02/13 P45270.05.14 TAS 103, TAS 110 & ASTM DL623 -AV42/14 P46520.10.14 ASTM D 1623 O ..' : .. 1 Q/03/ 14 P44360.10.14 TAS 103 & TAS 110 • • • %QM7/14 . . .„� P43290.10.14 ASTM D 1970 & TAR tt@• W/17/14. PLYG-SC 10130.06.16-3 TAS 103 & TAS I W 0 0 *. ;' 16: � � • � : PLYG-10130.06.16-1 ASTM D1970 & TAS tto* •O6/;7/ 66/27/16* PRI Asphalt Technologies PUSA-035-02-01 TAS 103 " *0• • • ®9%29/06• • • •.. PUSA-055-02-02 TAS 103 :0*:*: 12/10/07 • PUSA-089-02-01 TAS 103/ASTM D4798 & G).55 • • a406/09— 0 Momentum Technologies, Inc. JX20H7A TAS 103/ASTM D4798 & G155 '.:A4701/08 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. MIAMI•DADE 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 Expiration Date: 09/13/21 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 • y rn O• Anchor sheet mechanical) fastened to deck membrane adhered y .. . '• Anchor/Base Sheet: Soso.. :.. •..• One or more plies of ASTM D 226 Type H or ASTM D 2626. o ...... Fastening: • S s S s s Per FBC 1518.2 & 1518.4 Nails and tin caps 12" grid, 6" o.c. at a naWinum 4';bead lap. (fer •.. ' base sheet only) • • • •' ' Membrane: ..... Elastoflex S6 G, hot asphalt applied � • Surfacing: • • � • • • � • � • • • ...... • See General Limitations Below.Soo Deck Type 1: ss . . S• 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 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 4 of 8 INSTALLATION REQUIREMENTS: 1. 2. 3. 4. 5. 6. 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. 7. Flash vent pipes, stacks, chimneys and penetrations in compliance with Roof Assembly current Product Control Notice of Acceptance. 8. All protrusions or drains shall be initially taped with a 6" piece of underlayment. Thl fl4ftng tape s�a*fl be pressed in place and formed around the protrusion to ensure a tight fit. A second layer of liolystiCkshAV be applied over the underlayment. ...... GENERAL LIMITATIONS: 1. 2. 3. 4. 5. F1 'f t' i not art of this acce tance ...... .... •.•.•• ••.•• ••••• ire c ass > >ca ions p p .... • • Polystick Dual Pro, Polystick Tile Pro, Polystick TU Plus, Polystick MTS and Pof slf& MTS Ptus may be . • used in asphaltic shingles, wood shakes and shingles, non-structural metal roofing, roof the systems Wd quarry • • • 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 roofing and roof tile 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. Deck requirements shall be in compliance with applicable building code. 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. 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 MIAM4[IWDECOUIVTIf Expiration Date: 09/13/21 JAPPROVED1Approval Date: 07/06/17 Page 5 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 RECOMMENDATIOiS! • • • .. . .. . 1. Polyglass does accept the direct application of Polystick underlayment membranes to "eclecks. o4rNallers are..„• cautioned to refer to applicable local building codes prior to direct deck installation to d' MC this is aoceptablep • Please also refer to applicable Product Data Sheets of the corresponding products. • • 6 0 . :'. •. • . .. ..... 2. All rolls, with the exception of Polystick TU Plus should be back -nailed in selvage edge•,eWe as pec PWyglass..;,,. • Back Nailing Guide. Nails shall be, 11 gauge ring shank type, applied with a minimum 141V metal " as ...... required in Miami -Dade County or simplex type nail as otherwise allowable in other;!bA611C at a mintmum rate of 12" o.c. Polystick TU Plus should be back nailed in designated area marked "nail irrea, area paLi;4gr" on• • •• % the face of membrane, with the above stated nails and/or disks. The head lap membrallej5 to covej the •area be�..; 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 file 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 t/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 hOAMMADECOUNTY 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 RECOMMENPATIO 8s •: • •• • •• • END OF THIS ACCEPTANCE ' �••' ..•. •• • •••• • •• •••••• 0 so • e • • • • • •••• •••• • • 0 •• goes NOA No.: 17-0614.22 Expiration Date: 09/13/21 Approval Date: 07/06/17 Page 8 of 8 MilAM,1• 1 f 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) www.miamidade.eov/economy 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 to hive tlys product or material tested for quality assurance purposes. If this product or material fails to performs n the a ccep manner, ti" • manufacturer will incur the expense of such testing and the AHJ may immediately revoke, fiUdiP l or Impend the use ' of such product or material within their jurisdiction. RER reserves the right to revokV*11S acceptadde, if it• i,-o •: • determined by Miami -Dade County Product Control Section that this product or material fails to meet the r8quiremc%s .•; of the applicable building code. • 0600 see*• • 0. 00000 • This product is approved as described herein, and has been designed to comply with 'tt oFlorida g"ding Cadd.•' including the High Velocity Hurricane Zone of the Florida Building Code. " • • • • • • 006900 ...... • DESCRIPTION: ICP Adhesives Polyset® AH-160 , • • • LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state'l$d 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. 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 Dimensions Test Product Description Specifications • ICP Adhesives N/A TAS 101 Two component por}axetfiane foam adhesive Polyset®AH-160 669609 .a.. .. • •; ICP Adhesives Foam N/A Dispensing Equipment •..• .,...• Dispenser RTF1000 • • .... . .. ..... ICP Adhesives ProPacko N/A Dispensing Equipment; • •; • • • • • °.:..' .. .. .... ...... 30 & 100 •..... •• • • • • ease.. • s s s • PRODUCTS MANUFACTURED BY OTHERS: a • ° • • • • 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 Test Results Density ASTM D 1622 1.6 lbs./ft.3 Compressive Strength ASTM D 1621 18 PSI Parallel to rise 12 PSI Perpendicular to rise Tensile Strength ASTM D 1623 28 PSI Parallel to rise Water Absorption ASTM D 2127 0.08 Lbs./Ft2 Moisture Vapor Transmission ASTM E 96 3.1 Perm / Inch Dimensional Stability ASTM D 2126 +0.07% Volume Change @ -400 F., 2 weeks +6.0% Volume Change @158'F., 100% Humidity, 2 weeks Closed Cell Content ASTM D 2856 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. NOA No.: 17-0322.03 hOAMI•DADE COUNTY Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 2 of 11 EVIDENCE SUBMITTED: Test Agency Center for Applied Engineering Miles Laboratories Polymers Division Ramtech Laboratories, Inc. Southwest Research Institute Trinity Engineering Celotex Corp. Testing Services Test Identifier #94-060 257818-1 PA 25-7438-3 25-7438-4 25-7438-7 25-7492 NB-589-631 9637-92 01-6743-011 01-6739-062b[1] 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 •••�•• TAS 114 ."". ASTM D 1623 • • • • TAS 101 ••••�• TAS 123 •.••.. 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 04/3Q/93 ••.••• II/16/94 ®1W95 QU14 96 a1/%12 9�/�,llt2 12/28/98 03/02/99 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 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 the 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 61 G20-3 of the Florida Administrative Code. 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 beftr%apglication •. of any adhesive. The mix ratio between the "A" component and the "B" component sisattly maintained betweefl• •' 1.0-1.15 (A): 1.0 (B). """ 0 • 6. ICP Adhesives Polyset® AH-160 shall be applied with ICP Adhesives Foam Dispenser.RM000 Zr rG➢e • • • • • 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:40§dives • • • • . • Polyset® AH-160 has been dispensed. • .. . . .. 9. ICP Adhesives Polyset' AH-160 placement and minimum patty weight shall be in accordance with tico 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. 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 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 " :17 grPjm 13ar bead edge) 20-25 sq. inches each • • • • • bead • • • •••• . . Two Piece Barrel (Pan Tile) Two Piece 65-70 sq. inches grm•••• der pad .• ° LABELING: ° . . . . ...... All approved products listed herein shall be labeled and shall bear the imprint or identifiabieuvat4ig of the manufacturer's name or logo and following statement: "Miami -Dade County Product Control Approved"6o46tbe'Miami- Dade County Product Control Seal as shown below. 141AM H=E CCMA%W :7 I 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 # I l8ide,1 rfusWrth wtayra a xrel D.rQtYf ��a��h f,� �6t�re ecyule re], UeiSaru5mert7 A - --s • tor:. i E. Cl� — - NMI rntotgh rwt.c am tm l whe" rewly" , p.$4 ;WEh rap I ,r ,.,... . a.mr„t o e.r,l ti y t-A &n• COW** F•7ri. N"shroughpt•z-Tes •ems+ D �lB+n•iehl'.bl �'s?sare eeywr�l� 6fie�1arfapee�it.. '� !rt rrlJ• � Is, Battens Qpt -,a, Fasci• *444 rrrdk%s t • As [hlpstJy• Flat/Low Profile Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown, under the strengthening rib closest to the overlock of the the being set. 2. Continue in same manner. Insure approximately 17 (109.7 cm2) — 23 (148.4 cm2) square inch adhesive contact with the underside of the tile. •.•.•• • .• ••..•. Medium Profile / Double FWC Tile • •••• •. 1. Starting at the eave course' apply a dliniMum 2" •'; (50.8 mm) x 10" (254 nM4Xj" (25^H' foam paddy onto the underlay"e$f positiotlM shown under the pan portion o;NeMi a closest to the overlock of the tile being set. ; •' • •' • • . . .. 2. Continue in same manner. Insure appao*xi x ately 17 (109.7 cm2) — 23 (148.4 cm2) square inch adhesive 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 (CONTINUED) Neil T1"vu%1j pL tx srtiory" Paddy l9.r sAtk rib: When teirned undni.7 F,►M�°ate. ate. of ip Stile [G•ec�asin. 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 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) foamspaddy onto the underlayment positioned as shown under tfie pan • • • • ; • portion of the tile closest kcFill Overlock pftbe tile • being set. G••..• D G• GOODS* ••GOOD . :Does: 3. Continue in same manner!fr: logo appr$xrmitely 17D D (109.7 cm2) - 19 (122.6 crp�sgyare inch ,41besive GO:.. • contact with the underside.0 W tile. D .... • • G D G . •D...• . . . . ...... ...... . . .D.DG• NOA No.: 17-0322.03 Expiration Date: 05/10/22 Approval Date: 04/27/17 Page 8 of 11 ADHESIVE PLACEMENT DETAIL # 3 read duwgb plwdcceneeu pal* (banueen tiles) 1when required) Battens optional j ° Pad.dy 1r®der tile) single add ,+ � omtopottr7e tm sin aeesin. � � - �• BlePadd'i 011 on aad�laymeat 2:4 ter. asp OFlat6Low Profile Tile Nail through plastic ozn ent Single paddy unifer the (when required) Pad dylbetweentiles) Battens �� Paddy rundut2el opt�l r sir4pPaft? "lepaddyoo ymenr 2in. ` w Eave Closure EaveComse Fasda Medium PmflleTlle 1. On the eave course only, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown, under the strengthening rib for flat tile or under the pan portion of the tile for low or high profile tile closest to the overlock of the tile being set. Leave approximately 4" (101.6 mm) up from the eave edge free of foam to prevent the expanded adhesive from blocking the weep holes. Insure approximately 17-23 in' (109.7-148.4 cm) of adhesive contact with the underside of the the 2. Apply a 4" (101.6 mm)% J" (l 01.6 plm) X 1 " (25.4 . • mm) foam paddy onto 4w muderlay$iehJust below,.: • the second course line p"Coxed foam paddy : • • under the strengthening i i%461 flat toe,oP ender the • pan portion of the tile, c1bleSt to the'un(Wock Or': the second course tile td bt-Malled. O suse * * • • . .... ..... approximately 8-9 inZ (3 1.418.1 cm2) o adhesive • •.• • contact with the undersiFe.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) Nag thnsuo plastic oppeo S"e paWy wide dk a•rtua required �� Paddy ItKtczm t0es9 - eaateTs �'^/ � PsddllunQetU7e1 an single :: 4 'in. Paddy an Earn • ) fasaa �` • weaghola Eave aosure Drip edge High Profile Tile 3. Also apply a 2" (50.8 mm) x 4" (101.6 mm) x 3/4" (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 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. • •••••• •••• ••••• •• •• •••• •••••• • • • • • •••••• •• • • to • • • • 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 85 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 Eave closure (meta. 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 Rush at eave fine. 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 (4 L9.4 cjnl) — 79'M".6 cm2 e * • •. square inch adhesive'cAda4t with the underside •' of the pan tile. •••••• : •.•• ••••:• • •••••• . • 3. Turn covers upside dpW e4posit4 tjie0gpders1Uc ' of the tile. Apply a miflHftm 1" (2541nm) xsee* 00*00 1'li':•`. (254 mm) bead of ad 9&V* `dlryirect7 o tke inns; . . • edge of each side of ** � eo.vger tile. Le#ve a • approximately 3/4" (19 rP1rrD to 1 "0 (25.4 mm) • • • • o • from the outside edge of the tile, iWEN• free 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 cm2) - 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 sell seal ORNA Miami shores Village 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 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: I . 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 employees 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 BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signatur J. 2, Owner State of Florida County of Miami -Dade The foregoing was acknowledge before me this G � day of , 202,0. By. C1,qn ZL� who is personally known to me or has produced Notary: SEAL' •7 JEAN MY C0MV19'i.0N i FF MO EXPIRES: i ttuavy 17, 2020 Banded ihru kBtary Pubfrc Undeffl is