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RF-06-22-1606Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Issue Date: 07/28/2022 Location Address Parcel Number 436 NE 94TH ST, Miami Shores, FL 33138 1132060140340 Contacts Permit NO.: RF-06-22-1606 Permit Type: Roof Work Classification: Tile Permit Status: Approved Expiration: 01/30/2023 JASON DOMARK Owner Other: 3057267147 MASTER ROOFING INC Contractor MAYRELIS PRIETO Mobile: 7862025536 MAYRE1989@GMAIL.COM Description: RE -ROOF TILE Valuation: $ 35,000.00 Ins ection Requests I Total Sq Feet: 3,000.00 Fees Amount Application Fee - Other $50.00 CCF $21.00 DBPR Fee $4.50 DCA Fee $3.00 Education Surcharge $7.00 Roofing Fee $250.00 Technology Fee $7.50 Total: $343.00 Building Department Copy Payments Date Paid Amt Paid Total Fees $343.00 Credit Card 07/28/2022 $343.00 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 information is accurate and that all work will be done in compliance with all applicable laws regulating corptruction and zoning. Futhermore, I authorize the above named contractor to do the work stated. Owner / Applicant / Contractor I Agent Date July 28, 2022 Page 2 of 2 Miami Shores Village ENTERED Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 JUN 2 3 2022 INSPECTION LINE PHONE NUMBER: (305) 762-4949 pFB�C 201Z BUILDING Master Permit No. �'d�► -21 —� �Dti' PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ROOFING ❑ REVISION ❑ EXTENSION ORENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 436 NE 94 ST City: Miami Shores County: Miami Dade Zip: Folio/Parcel#:1132060140340 Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder):JASON DOMARK Phone#:305-726-7147 Address:436 NE 94 ST City: MIAMI SHORES State: FL Zip: 33138 Tenant/Lessee Name: Phone#: Email: 1Q_'bQV\ I �0W10,4V1&1 A0,J- LD"A CONTRACTOR: Company Name: MASTER ROOFING INC Phone#: 786-202-5536 Address: 5030 SW 170 AVE AA&4✓e (0, i4 Ca d. Wta_L Lp V" City: SOUTHWEST RANCHES State: FL V Zip: 33331 Qualifier Name: MAYRELIS PRIETO Phone#: 786-202-5536 State Certification or Registration #: CCC1330820 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $35000 Square/Linear Footage of Work: 3000 Type of Work: ❑ Addition ❑ Alteration ❑ New ❑■ Repair/Replace ❑ Demolition Description of Work: REROOF TILE Specify color of color thru tile: 60 I G f ,u2,t Submittal Fee $ Permit Fee $ CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Technology Fee $ Training/Education Fee $ Double Fee $ Structural Reviews $ Bond $ TOTAL FEE NOW DUE $ (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State 213 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 ' \/`l./ " Signature OWNER or AGENT C04TRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this D� day of J 20 7 7-• by 10 day of a M e, 20 -�, by ywv\ �l �l/AJb0yyy li {l who is personally known to 7f'OI" 1 �Annf/� y C r-,ky . who is personally known to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: M_ r Sign: Print: f a, r;�ei Print: t) ary Publio State of Florida Seal:E7Exp- Seal: Flontle cYYrelie io, commission i F NoteypubNc Smote of y HH 22005/ Maria Cruz u24tzoze Commisaon HH 017233 �` Expe0710a 2024+++++++++ ++++++I++++++++++++++++++ +++ + +++++++++ APPROVED BY tans Examiner Zoning Structural Review (Revised02/24/2014) Clerk Miami Shores Village - BUILDING DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33138 305-795-2204 www.msvfl.gov OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE -BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department 10050 NE 2"d Ave Miami Shores, FI 33138 m Owner's Name: JAS.Av% �APV,% ,( Property Address: ► E q4 trr Roofing Permit Number: Dear Building Offici I0 I i4�6©v� W,0_1 V� 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. WThe 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) A ` DWCt_ V1C_ Signat a Print Name State of Florida, Miami Dade County 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 10 day of T- Ae, 20� A j Notary Public State of Florida Notary Public, State of Florida at Large 026 When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than $300,000.00, and the building was not constructed with FBC nor a 1994 SFBC. Then you must provide a building application from a General Contractor for the Roof to Wall connection Hurricane Mitigation. For Forms and Applications click here: http://bldg.miamishoresvillage.com/WebLink/Browse.aspx?id=118080&dbid=0&repo=Mia miShoresVillage Rev01142021 Owner affidavit of exemption Page 1 of 1 I TAS 106 TEST RESULTS REPORT GENERAL INFORMATION YP BEST SERVICES INC UP LIFT TEST EXPERTS LAB. CERTIFICACION NO.22.0120.06 12170 S.W.128Th CT MIAMI, FL 33186 Phone: 786-721.2324 email: ypbestservices@gmaii.com Owner's Name: JASON DOMARK JOB Address: 436 NE 94 St, Miami Shores, FL 33138 Roofing Contractor: MASTER ROOFING INC Type of Tile: EAGLE CAPISTRANO Approximate roof Height: 24 Approximate Square footage of roof: Required testing force: 35 lbs. Date Tested: 06/8/2023 24 �A/ �F3 Permit#: RF-06-22-1606 _ Date Installed: _ Roof pitch: 4/12 ft2 Numbers of Tests: 84 TEST LOCATION PASS FAIL CORNER 6 PERIMETER 25 RIDGER 29 FIELD 24 TOTAL 84 IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106. THIS ROOF ASSEMBLY DOES PASS THE STATIC UPLIFT QUALITY CONTROL TEST. THIS TAS 106 TEST HAS BEEN PERFORMED IN FULL ACCORDANCE TO THE REQUIREMENTS OF DADE COUNTY, WITH NO DEVIATIONS THIS REPORT IS NOT GUARANTEED IN CASE OF NATURAL DISASTERS. 110A , uilbr., P.6 # 2 '��nnnIIIION TAS 106 TEST RESULTS REPORT GENERAL INFORMATION YP BEST SERVICES INC UP LIFT TEST EXPERTS LAB. CERTIFICACION NO.22-0120.06 12170 S.W.128Th CT MIAMI, FL 33186 Phone: 786-721-2324 small: ypbestservices@gmall.com ROOF DIAGRAM 25 24. 36 1 -8 33 7 3S � 25 =23 31. 32 36 g 34 37 39. 84 40 � 46 4$ 22 10 42 43 45 47 51 .91 41 11 SO 21, 43- 4S S3 - 52 7b 83 20 SO 54 58 42 L2 82 7s .56. 61 55 83 19 84 13 75 S7 67 72 70 2 33 68 fS 14 17 17 73 71 1 15 C I C) P; elt EM Florida Building Code 7th Edition (2020) High Velocity Hurricane Zone Uniform Roofing Application Form for Miami -Dade County Master Permit Number: Contractor's Name: Job Address: ❑ Low Slope �� D Y�s�i�5hingles JUN 2 3 2022 gy: ❑ New Roof ❑ Repair Low Slope Roof Area (ftZ) Are there gas vents on the roof? Section A (General Information) ROOF CATEGORY ❑ Mechanically Fastened Tile ❑ Metal Panel/Shingles ROOF TYPE ❑ Maintenance Process Number: Subject to compliance -With qI Foderal, State an,cLCounty rules and regulations. / Permit# fz" Mortar / Adhesive Set Tile ❑ Wood Shingles / Shakes ROOF SYSTEM INFORMATION Steep Sloped Roof Area (ftZ) �,�a000 O Yes CN No If Yes what type? Iff Reroofing ❑ Recovering Total (ftZ) 3P00 ONatural O LPX Is there an existing roof top Solar System? 0 Yes CVNo If yes will it be Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, dimensions of sections and levels, clearly identify dimensions of elevated 60 �0 2L% ? OYes ONo )w drains. Include of parapets. ENTERED AUG 0 s ZQZZ Florida Building Code 7th Edition (2020) High Velocity Hurricane Zone Uniform Roofing Application Form for Mianiff'b ct ouC n-�— Section D (Steep Sloped Roof System) yn, Roof System Manufacturer: R041� t4 " Product Control Number: Z I -0 315. 07, Minimum Design Wind Pressures, From Applicable RAS 127 Table or Calculations: An2Ji u_uA fLdd�.t Zone1: —' `4 Zone 2e: � Zone2n: -10 Zone 2r: —I00 Zone 3e: -10e Zone 3r: -3 «d]] Slope Range: Q? 2:12 to <_ 4:12 Roof Shape: Q All Hip Roof Deck Type: 0>4:12to:56:12 0>6:12to!512:12 Q/Gable Roof or Partial Gable/Hip Roof Underlayment Type: �o,r� Fe- + ¢ f t> 7-2- Roof Slope: 3 : 12 Insulation: Ridge Ventilation? 14 Mean Roof Height: ZOt CITY COPY Miami Shores Village puifding Depajrtmenl Zoning Dept. Date Building Dept. Dat Subject to complian with all a eral, State and County rules and regulations. Perm it# 2�—ZZ - ZL�S Fire Barrier: N lq Fastener Type & Spacing: oG Cap Sheet Type: Cap Sheet Attachment: e "'b Tu- !7 Roof Covering: Drip Edge Type & Size: Z& Florida Building Code 7th Edition (2020) High Velocity Hurricane Zone Uniform Roofing Application Form for Miami -Dade County Section E (Tile Calculations) For Moment based tile systems, choose Method 1. Compare the values for Mrwith the values from Mr. If the Mf values are 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 127" Enter positive uplift pressures when using this table ( Zone 1: x A 0. 2--R= qj) — Mg: Mrz 113roduct Approval Mf: ,39. 3L ( Zone 2e: — }� x A _ .p.qqj ) — Mg: (� . 9Q = Mrze �3. s�B Product Approval Mf: 3�• �' ( Zone 2n: 1100 x A 21.U0 ) — Mg: & - = Mr2n ;�2 -!9Product Approval Mf: 3 ? • �` ( Zone 2r: —1 D x A (2• Mg: = Mr2r 22.g Product Approval Mf: 31. 3L ( Zone 3e: --10 x A 0 fi =�9A110 ) — Mg: &�q9 = Mr3e Z2..Product Approval Mf: 313- _' ( Zone 3r:— x = 35'• * — Mg: (P • T = Mrar Product Approval Mf: 3� • } Tile attachment method. Alternate Tile attachment method: For Uplift Based tile systems use Method 3. Compare 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 tile attachment method is acceptable. Method 3* "Uplift Based Tile Calculations per RAS 127" (Zone 1: x L = xW= (Zone 2e: x L = x W = (Zone 2n: x L = x W = (Zone 2r: x L = x W = (Zone 3e: x L = x W = (Zone 3r: x L = x W = _ ( w) x cos 0 ) = Fri Product Approval F': (w) x cos 0 ) = Fr2e Product Approval F': (w) x cos 0 } = Fr2n Product Approval F': (w) x cos 0 ) = Fr2r Product Approval F': _) — (w) x cos 0 ) = Fr3e Product Approval F': — (w) x cos 0 ) = Fr3r Product Approval F': *Method 2 "Simplified Tile Calculations" only applicable in Broward County. Where to obtain information Description Symbol Where to Find Design Pressure Zones 1, 2e, 2n, 2r,3e, 3r From the applicable Table in RAS-127 or be an engineering analysis prepared by a PE based upon ASCE 7 Mean Roof Height H Job Site Roof Slope 0 Job Site Aerodynamic Multiplier x Product Approval / Notice of Acceptance Restoring Moment due to Gravity Mg Product Approval / Notice of Acceptance Attachment Resistance Mf Product Approval / Notice of Acceptance Required Moment Resistance Mr Calculated Minimum Attachment Resistance F' Product Approval / Notice of Acceptance Required Uplift Resistance Fr Calculated Average Tile Weight w Product Approval / Notice of Acceptance Tile Dimensions L=Length W= Width Product Approval / Notice of Acceptance All calculations must be submitted to the Building Official at the time of permit application. AMI-DADE MIAMI. EI■ MICONTROL 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.goy/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 materials. The documentation submitted has been reviewed and accepted by Miami -Dade County RER -Product Control Section to be used in Miami -Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Section (in Miami -Dade County) and/or the AHJ (in areas other than Miami -Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: High 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 renews NOA# 19-1030.04 and consists of pages 1 through 9. The submitted documentation was reviewed by Alex Tigera. NOA No. 21-0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 Page 1 of 9 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Concrete 1. SCOPE: This approves a new roofing system using High 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 Applicant High Profile Concrete Tile Test Dimensions Specifications Lenght = 17" TAS 112 Width = 12 1/4" Type 1 a Thickness = '/2" Class III Trim Pieces Lenght = varies TAS 112 Width = varies varying thickness 2.1 PRODUCTS MANUFACTURED BY OTHERS Product Name ICP Adhesives Polyseto AH-160 Product Description Two component polyurethane foam adhesive. Product Description High profile concrete roof tile. For direct deck or battened nail -on applications. Accessory trim, concrete roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. TILE BONDTM Roof Tile Adhesive Single component polyurethane foam roof tile adhesive. DAP Foam Touch N Seal Two component polyurethane StormBond® 2 Roof Tile Adhesive foam adhesive. 2.2 MANUFACTURING LOCATION 2.2.1. Sumterville, FL Manufacturer (With Current NOA) ICP Adhesives and Sealants, Inc. DuPont de Nemours, Inc. DAP Foam, Inc. NOA No. 21-0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 Page 2 of 9 2.3 EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date PRI Asphalt Technologies ERPF-001-02-03 TAS-112 Aug. 2006 Redland Technologies 7161-03 Static Uplift Testing Dec. 1991 Appendix III TAS 102 & 102(A) Redland Technologies Letter Dated Aug. 1, Wind Tunnel Testing Aug. 1994 1994 TAS 108 (Nail -On) Redland Technologies P09647-01 Wind Tunnel Testing Aug. 1994 TAS 108 (Mortar Set) Redland Technologies P0402 Withdrawal Resistance Testing of screw Sept. 1993 vs. smooth shank nails The Center for Applied 94-083 Static Uplift Testing April 1994 Engineering, Inc. TAS 101 (Adhesive Set) The Center for Applied 94-084 Static Uplift Testing May 1994 Engineering, Inc. TAS 101 (Mortar Set) The Center for Applied 25-7094-(3, 6 & 9) Static Uplift Testing Oct. 1994 Engineering, Inc. TAS 102 The Center for Applied 25-7120-(1 & 2) Static Uplift Testing Nov. 1994 Engineering, Inc. TAS 102 The Center for Applied 25-7183-(3 & 4) Static Uplift Testing Feb. 1995 Engineering, Inc. TAS 102 The Center for Applied 25-7214-(3, 4, &7) Static Uplift Testing March, 1995 Engineering, Inc. TAS 102 The Center for Applied 25-7804-4 Static Uplift Testing Sep. 1996 Engineering, Inc. TAS 102 Celotex Corporation 520111-3 Static Uplift Testing Dec. 1998 Testing Services TAS 101 Celotex Corporation 520191-2-1 Static Uplift Testing March 1999 Testing Services TAS 101 Walker Engineering, Inc. Calculations Aerodynamic Multiplier Sep. 2006 ATL of South Florida RT0317.03-21 TAS-112 03/27/21 PRI Construction Materials DAPF-001-02-01 Static Uplift Testing 11/30/17 DAPF-004-02-03 (Adhesive) 07/09/ 18 DAPF-004-02-04 TAS 101 07/09/ 18 NEMO ETC, LLC 4c-DPBS-20- TAS 101 12/17/20 LSOTM-01.D.R1 NOA No. 21-0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 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 herin shall have aquality assurance audit in accordance with the Florida Building Code and Rule 61 G20-3 of the Florida Administrative Code. 4. INSTALLATION 4.1 Eagle Roofing Products LLC, High Profile Concrete Tile and its components shall be installed in strict 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 (Ibfl Length -I (ft) Width-w (ft) High Profile Concrete Tile 10 1.417 1.04 Table 2: Aerodynamic Multipliers - A (ft3) Tile Profile A (ft3) Batten Application A (ft) Direct Deck Application High Profile Concrete Tile 0.300 0.277 Table 3: Restoring Moments due to Gravity - Mg (ft-Ibfl Tile Profile 2" & 3":12 4":12" 5":12" 6":12" 711:12" or greater High Profile Concrete Tile Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck NIA 6.99 6.57 6.88 6.44 6.73 6.28 6.56 6.10 6.38 NOA No. 21-0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 Page 4 of 9 Table 4: Attachment Resistance Expressed as a Moment - Mr (ft-lbf) for Nail -On Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19/32" plywood) Battens High Profile Concrete Tile 2-10d Ring Shank Nails 28.6 41.2 19.4 1-10d Smooth or Screw Shank Nail 5.1 6.8 2.8 2-10d Smooth or Screw Shank Nails 6.9 9.2 7.3 1 #8 Screw 20.7 20.7 18.1 2 #8 Screw 43.2 43.2 29.8 1-10d Smooth or Screw Shank Nail Field Clip) 23.1 23.1 19.0 1-10d Smooth or Screw Shank Nail Eave Clip) 29.3 29.3 24.0 2-10d Smooth or Screw Shank Nails Field Clip) 27.6 27.6 38.6 2-10d Smooth or Screw Shank Nails Eave Clip) 38.1 38.1 41.8 2-10d Ring Shank Nails' 33.1 48.1 45.2 1. Installation with a 4" the headlap and fasteners are located a min. of 2'/z"from head of tile. Table 5: Attachment Resistance Expressed as a Moment Mr (ft-lbf) for Two Patty Adhesive Set Systems Tile Tile Application' Minimum Attachment Profile Resistance High Profile Concrete Tile Dupont De Nemours TILE BOND TM Roof Tile Adhesive 192 Dupont De Nemours TILE BOND Tm Roof Tile Adhesive 583 ICP Adhesives Pol set® AH-160 29.3 4 DAP Foam Touch N Seal StormBond® 2 Roof Tile Adhesive 495 1 See manufactures component approval for installation requirements. 2 Dupont De Nemours TILE BOND TM Roof Tile Adhesive weight per patty 8 grams. 3 Dupont De Nemours TILE BOND TM Roof Tile Adhesive weight per patty 10 and 20 grams. 4 ICP Adhesives Polyset® AH-160 weight per patty 8 grams. 5 DAP Foam Touch N Seal StormBond® 2 Roof Tile Adhesive weight per paddy 8 grams. *NOTE * For # 2 placement see Detail 3 B on page 8 of 9 For # 3 placement see Detail 3 C on page 9 of 9 NOA No. 21-0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 Page 5 of 9 Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-lbf for Single Patty Adhesive Set Systems Tile Tile Applications Minimum Attachment Profile Resistance High Profile Concrete Tile ICP Adhesives Polyset® AH-160 66.5 7 ICP Adhesives Polyset® AH-160 38.78 DAP Foam Touch N Seal StormBond® 2 Roof Tile Adhesive 619 DAP Foam Touch N Seal StormBond® 2 Roof Tile Adhesive 3710 6 See manufactures component approval for installation requirements. 7 ICP Adhesives Polyset - AH-160 Large paddy placement of 63 grams. 8 ICP Adhesives Polyset - AH-160 Medium paddy placement of 24 grams. 9 DAP Foam Touch N Seal StormBond® 2 Roof Tile Adhesive weight per paddy 60 grams. 10 DAP Foam Touch N Seal StormBond® 2 Roof Tile Adhesive weight per paddy 30 grams. Table 7: Attachment Resistance Expressed as a Moment - Mf (ft-lbq for Mortar Set Systems Tile Profile Tile Application Attachment Resistance High Profile Concrete Tile Mortar Set11 24.5 11 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". EAGLE1 In 0 FLORIDA (LOCATED ON UNDERSIDE OF TILE) OR EAGLE FL (LOCATED ON FRONTSIDE OF TILE) NOA No. 21-0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 Page 6 of 9 (). 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. PROFILE DRAWING NAIL HOL11 HIGH PROFILE CONCRETE TILE NOA No. 21.0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 Page 7 of 9 DETAIL 3 B Placement Min. Tile Contact Area, inz per Tile Attachment: One (1) paddy, minimum 4-in. x 4-in. x l-in. to underlayment and one (1) bead/paddy, minimum 1-in. x 1- in. x 8-in. Adhesive Rates: 8 gram/paddy 32 NOA No. 21-0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 Page 8 of 9 DETAIL 3 C Placement Min. Tile Contact Area, in2per Tile Attachment: One (1) 1-in. x 1-in. x 8-in. paddy to the center of the tile underside (3" down from the headlap) mating to one (1) 1-in. x 1-in. x 8-in. paddy applied to the deck Rates: 10 and 20 gram paddys END OF THIS ACCEPTANCE 15 NOA No. 21-0315.02 Expiration Date: 10/05/26 Approval Date: 05/06/21 Page 9 of 9 ENTERED AH 0 8 Z022 PER 100 88.5 Tiles (Y headlap) �"-�j- A SQ FT I 880 Pounds (apprA.) Tigh S-profile tile, our Capistrano is semi -cylindrical and is the lost traditionally recognized of all tile profiles. While you may think a Capistrano tile roof is suitable for only Spanish or Italian architecture, it actually offers stunning good looks that work well with any style, as it pairs nicely with stucco, stone or brick siding. ...,, used widely on residential, commercial, military and institutional buildings throughout the United States. N ---......, uraro-nuesol�wcmo, creomstyl Ref. 0.32 Emi: 0.90 SRI: 33 ASRI: 34 CRRC: 0918-0062 LEW 3" I.D. 35113 Sierra Madre-HuesolChoRool, BlodrSlreokt Ref:.11 Erni:.92 SRI:9 ASRI: 12 CRRC: 0918-0111 3520 Weathered Terracotta Flashed-Hueso/ligh(reoorotta Blork,RedS&wxs Ref .19 Emil: .93 SRI: 19 ASRI: 20 CRRC: 0918-0038 Notice TO ensure your sahilactlon with your the choice, v,e reques, you 061am a current Zile sample; or request addresses in your area from your local A.5Rl actual: At. A.SR1 Al. Design Center Eagle Representative. 25 MI®EDM)ADE MIAMI-DARE 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.eow/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 the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: 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.17-0614.22 and consists of pages 1 through 7. The submitted documentation was reviewed by Jorge L. Acebo. NOA No.: 21-0602.14 Expiration Date: 09/13/22 Approval Date: 08/26/21 Page I of 7 ROOFING COMPONENT APPROVAL Category: Roofing Sub -Category: Underlayment Material: SBS, APP PRODUCTS DESCRIPTION: Test Product Product Dimensions Specification Description Polystick IR-Xe 65' x 3' Or 33.4' x ASTM D 1970 A fine granular/sand top surface self -adhering, APP Manufacturing 3' polymer modified, fiberglass reinforced, bituminous sheet Location #1 & #2 material for use as an underlayment in sloped roof 60 mils thick assemblies. Designed as an ice & rain shield. Polystick TU Max 65'8" x 3'3-3/8" TAS 103 and A rubberized asphalt self -adhering, polyester reinforced Manufacturing 60 mils thick ASTM D 1970 waterproofing membrane. Designed as a a roof tile Location #1 & #2 underlayment. Polystick TU P 32' 10" x 3'3 3/s" TAS 103 and A rubberized asphalt waterproofing membrane, glass - 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 6518" 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 3133/8" 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. Elastoflex S6 G 32'10" x 313/8TAS 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. MANUFACTURING PLANTS: 1. Hazelton, PA 2. Winter Haven, FL NOA No.: 21-0602.14 Expiration Date: 09/13/22 Approval Date: 08/26/21 Page 2 of 7 Test Azency Trinity ( ERD LABELING: EVIDENCE SUBMITTED Test Identifier Test Name/Reuort P37300.10.11 P37590.07.13-1 P45270.05.14 P46520.10.14 P44360.10.14 P43290.10.14 PLYG-SC 10130.06.16-3 PLYG-1013 0.06.16-1 PLYG-SC 10130.09.16 PLYG-SC 13035.08.17 TAS 110/ASTM D4798 & D 1970 ASTM D6164 TAS 103, TAS 110 & ASTM D 1623 ASTM D 1623 TAS 103 & TAS 110 ASTM D 1970 & TAS 110 TAS 103 & TAS 110 ASTM D 1970 & TAS 110 ASTM D 1623 TAS 103 & ASTM D4798 Date 10/19/11 07/02/ 13 05/12/14 10/03/14 10/07/14 10/17/14 06/27/16 06/27/16 09/22/16 10/32/17 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. 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.: 21-0602.14 Expiration Date: 09/13/22 Approval Date: 08/26/21 Page 3 of 7 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 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 minimum 4" head lap. (for base sheet only) Membrane: Elastoflex S6 G, hot asphalt applied Surfacing: See General Limitations Below. 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 A 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.: 21-0602.14 Expiration Date: 09/13/22 Approval Date: 08/26/21 Page 4 of 7 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 Product Control Notice of Acceptance. 8. All protrusions or drains shall be initially taped with a 6" piece of underlayment. The flashing tape shall be pressed in place and formed around the protrusion to ensure a tight fit. A second layer of Polystick shall be applied over the underlayment. GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance. 2. Polystick TU Plus, Polystick MTS and Polystick MTS Plus may be used in asphaltic shingles, wood shakes and shingles, non-structural metal roofing, roof tile systems and 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. 3. Deck requirements shall be in compliance with applicable building code. 4. Polystick IR-Xe, 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 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 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) Polystick MTS Polystick IR-Xe Elastoflex S6 G Polystick TU Plus Polystick TU P Polystick TU Max Polystick MTS Plus Winter Haven, FL 180 90 180 180 180 180 180 Hazelton PA N/A 90 N/A 180 N/A 180 N/A 7. 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.: 21-0602.14 Expiration Date: 09/13/22 Approval Date: 08/26/21 Page 5 of 8. In roof tile application, data for the attachment resistance of roof tiles shall be as set forth in the roof tile manufacturer's Notice of Acceptance. Polystick TU Max, Polystick TU Plus or Elastoflex S6 G may be used in both adhesive set and 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) file assemblies, the maximum roof slope shall be as follows: (See Table Below) Tile Polystick Elastoflex Polystick TU Plus, Polystick Polystick System (E3) Profile MTS S6 G Polystick TU P TU Max MTS Plus MTS Plus with TU Plus Flat Tile Prohibited 4:12 6:12 6:12 5:12 6:12 without battens Profiled Prohibited 4:12 6:12 6:12 4:12 6:12 Tile without battens The above slope limitations can be exceeded only by using battens in accordance with the Approved Tile System Notice of Acceptance and applicable Florida Building Code requirements. When battens are required, they shall be utilized during loading and installation of tiles. 10. Care should be taken during the loading procedure to keep foot traffic to a minimum and to avoid dropping of tile directly on the underlayment. Refer to Polyglass' Tile loading detail below for loading procedure — two tiles laid perpendicular to slope followed by a maximum four tile stack parallel to the slope, for a total of 6 tiles — for all underlayments except Polystick MTS which shall be loaded onto battens. Roofing Tiles (6 Max. Per stack) o. 12 0 6� N tJ �_✓ m.r Ueck preparm xm gC - POLYSIRu 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 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 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 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. NOA No.: 21-0602.14 MIAWnADECOUNTY Expiration Date: 09/13/22 Approval Date: 08/26/21 Page 6 of 7 POLYGLASS GENERAL APPLICATION GUIDELINES FOR POLYSTICK MEMBRANES PLEASE CHECK WITH LOCAL BUILDING CODES REGARDING LIMITATIONS OF SPECIFIC APPLICATIONS. LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND RECOMMENDATIONS. 1. Polyglass does accept the direct application of Polystick underlayment membranes to wood decks. Installers are cautioned to refer to applicable local building codes prior to direct deck installation to ensure this is acceptable. Please also refer to applicable Product Data Sheets of the corresponding products. 2. All rolls, with the exception of Polystick TU Plus should be back -nailed in selvage edge seam as per Polyglass Back Nailing Guide. Nails shall be, 11 gauge ring shank type, applied with a minimum 1 %" metal disk as required in Miami -Dade County or simplex type nail as otherwise allowable in other regions, at a minimum rate of 12" o.c. Polystick TU Plus should be back nailed in designated area marked "nail area, area para clavar" on the face of membrane, with the above stated nails and/or disks. The head lap membrane is to cover the area being back -nailed. (Please refer to applicable local building codes prior to installation.) 3. All seal lap seams (selvage laps) must be rolled with a hand roller to ensure full contact. 4. All fabric over fabric; and granule over granule end laps, shall have a 6" wide, uniform layer of Polyglass POLYPLUS 50, XtraFlex 50 Premium Modified Wet/Dry Cement or Polyglass PG 500 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 riles 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 T712" or greater. It is suggested that on pitch/slopes in excess of 6 VV/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 50, XtraFlex 50 Premium Modified Wet/Dry Cement or Polyglass PG 500 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. 10. All self -adhered membranes must be rolled to ensure full contact with approved substrates. Polyglass requires a minimum of 40 lbs for a weighted roller for the rolling of the field membrane. Hand rollers are acceptable for rolling of patches or small areas of the roof. Brooming may be used where slope prohibits rolling. 11. All approved substrates should be dry, clean and properly prepared, before any application of Polystick membranes commences. An approved substrate technical bulletin can be furnished upon request. It is recommended to refer to applicable building codes prior to installation to verify acceptable substrates. 12. The Polyglass Miami -Dade Notice of Acceptance (NOA) approval for Polystick membranes can be furnished upon request by our Technical Services Department by calling 1 (800) 894-4563. 13. Questions in regards to the application of Polyglass products should be directed to our Technical Services Department at 1 (800) 894-4563. 14. Polyglass recommends that applicators follow good roofing practices and applicable procedures as outlined by the National Roofing Contractors Association (NRCA). PLEASE CHECK WITH LOCAL BUILDING CODES REGARDING LIMITATIONS OF SPECIFIC APPLICATIONS. LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND RECOMMENDATIONS. END OF THIS ACCEPTANCE NOA No.: 21-0602.14 Expiration Date: 09/13/22 Approval Date: 08/26/21 Page 7 of 7 COUNTY MICONTR MIMI®� PRODUCT CONTROL SECTION L • 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 .miamidade.sov/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 have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: 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 20-1124.07 and consists of pages 1 through 11. The submitted documentation was reviewed by Alex Tigera. NOA No.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 1 of 11 ROOFING COMPONENT APPROVAL: Category: Roofing Sub Category: Roof tile adhesive Materials: Polyurethane SCOPE: This approves 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 Polyset® AH-160. PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test Product Description Specifications Polyset®AH-160 N/A TAS 101 Two component polyurethane foam adhesive ICP Adhesives Foam N/A Dispensing Equipment Dispenser RTF1000 ICP Adhesives ProPacl& 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 Polyset® AH-160 roof tile adhesive. MANUFACTURING LOCATION: 1. Tomball, TX. PHYSICAL PROPERTIES: Property Test Results Density @ 73T ASTM D 1622 2.1 lbs./ft 3 Compressive Strength ASTM D 1621 18 PSI Parallel to rise 14 PSI Perpendicular to rise Tensile Strength ASTM. D 1623 29 PSI Parallel to rise Water Absorption ASTM D2842 0% Moisture Vapor Transmission ASTM E96 2.3 Perms Dimensional Stability ASTM D2126 +0.07% Volume Change @ -400 F., 2 weeks +6.0% Volume Change @158°F., 100% Humidity, 2 weeks Closed Cell Content ASTM D6226 94% 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.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 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 NEMO ETC, LLC Test Identifier Test Name/Report Date #94-060 TAS 101 04/08/94 257818-1PA TAS 101 12/16/96 25-7438-3 SSTD 11-93 10/25/95 25-7438-4 25-7438-7 SSTD 11-93 11/02/95 25-7492 SSTD 11-93 12/12/95 NB-589-631 ASTM D 1623 02/01/94 9637-92 ASTM E 108 04/30/93 01-6743-011 ASTM E 108 11/16/94 O 1-673 9-062b [ l) ASTM E 84 01 / 16/95 7050.02.96-1 TAS 114 03/14/96 P36700.04.12 ASTM D 1623 04/18/12 P39740.02.12 TAS 101 02/21/12 TAS 123 528454-2-1 TAS 101 10/23/98 528454-9-1 528454-10-1 520109-1 TAS 101 12/28/98 520109-2 520109-3 520109-6 520109-7 520191-1 TAS 101 03/02/99 520109-2-1 4p-ICP-20-SSLAP-01.B Physical Properties 11/11/20 LIMITATIONS: 1. Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. 2. Polysee 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 Polyse& 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 61 G20-3 of the Florida Administrative Code. NOA No.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 3 of 11 INSTALLATION: 1. Polyset® AH-160 may be used with any roof tile assembly having a current NOA that lists attachment resistance values with the use of Polyset® AH-160. 2. Polyset® AH-160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof file assembly's adhesive attachment with the use of 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. 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 RTF 1000 dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0-1.15 (A): 1.0 (B). 6. Polyset® AH-160 shall be applied with ICP Adhesives Foam Dispenser RTF1000 or ICP Adhesives ProPacko 30 & 100 dispensing equipment only. 7. 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 Polyset' AH-160 has been dispensed. 9. Polyset® AH-160 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. NOA No.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 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 grams per bead edge) 20-25 sq. inches each bead Two Piece Barrel (Pan Tile) Two Piece 65-70 sq. inches 34 grams under pan LABELING: All approved products listed herein shall be labeled and shall bear the imprint or identifiable marking of the manufacturer's name or logo and following statement: "Miami -Dade County Product Control Approved" or the 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.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 5 of 11 ADHESIVE PLACEMENT DETAIL # 1 (Baneathnle) Closure Fascia Nail through piastI e paddy (Beneath nle) (whenrequired) Underlayment 10in.a 21n.wide Battens /optional Y Eave Course Fascia Weephole 101n 2In Eave closure Dripedge Flat/Low Profile Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown, under the strengthening rib closest to the overlock of the tile being set. 2, Continue in same manner. Insure approximately 17 (109.7 cm2) — 23 (148.4 cm2) square inch adhesive contact with the underside of the tile. Medium Profile / Double Pan Tile I. 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. 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.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 6 of 11 ADHESIVE PLACEMENT DETAIL # 2 Nail through plastic wment Paddy(Beneathnle) (when required) underlayment 1 a 7 in. 2In. Batteasoptional ° Eaw Course ° 0 10In. Fascia 2In caw Closuro Nail through plastic cement (when required) Battensoptional loin. Paddy (Beneath Tile) Eave Closure Fascia Flat/Low Profile Tile Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 Tom) foam paddy onto the underlayment positioned as shown under the strengthening rib of the tile closest to the overlock of the tile being set. Insure approximately 17 (109.7 cm2) — 23 (148.4 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 of the file being set. 3. Continue in same manner. Insure approximately 10" (64.5 cm) - 12 (77.4 cm2) square inch adhesive contact with the underside of the tile. Medium Profile / Double Pan Tile I. Starting at the eave course, apply a minimum 2" (50.8 Turn) 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 the pan portion of the tile closest to the overlock of the tile being set. 3. Continue in same manner. Insure approximately 12" (77.4 cm2) - 14 (90.3 cm2) square inch adhesive contact with the underside of the tile. (Instructions continued on nest page) NOA No.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 7 of 11 (when Undedayment l'6; ADHESPYE PLACEMENT DETAIL # 2 (CONTINUED) edge High Profile / Single Pan Tile Starting at the cave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under the pan portion of the tile closest to the overlock of the tile being set. Insure approximately 17 (109.7 cm2) — 23 (148.4 cm2) square inch adhesive contact with the underside of the tile. 2. At the second course, apply a minimum 2" (50.8mm) x 7" (177.8 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under the pan portion of the tile closest to the overlock of the tile being set. 3. Continue in same manner. Insure approximately 17" (109.7 cm2) - 19 (122.6 cm) square inch adhesive contact with the underside of the tile. NOA No.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 8 of 11 in. ADHESIVE PLACEMENT DETAIL # 3 cemem "e `E 231461. loin: -.� ....� r••, FlatlLow Prof lle The Nall through plastic cement Single paddy under the (when respired) Paddy lbetween til es i Battem Paddy hinder tit e. optimal M�ile. .4in. r 2z4In. paddy on t toin.'s �. `. 21n. —Ea Clos.,, En Cow Fascia Medium Profile Tile On the eave course only, apply a minimum 2" (50.8 mm) x 10" (254 mm) x V (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 tile 2. Apply a 4" (101.6 mm) x 4" (101.6 mm) x 1" (25.4 mm) foam paddy onto the underlayment just below the second course line positioned foam paddy under the strengthening rib for flat tile, or under the pan portion of the tile, closest to the underlock for the second course tile to be installed. Insure approximately 8-9 in2 (51.6-58.1 cm2) of adhesive contact with the underside of the tile. (Instructions continued on next page) NOA No.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 9 of 11 ADHESIVE PLACEMENT DETAIL # 3 (CONTINUED) Nail through plasticce 51 epaddyundertile (when required) Paddy (between tiles) Battens ,�: optional IZ� q paddy tundertllel r Singlepaddy �fonundedaymen l 4x4in. single 2 x 4 in. paddyy on top oftile-- Eave Course Fascia Weephoie loin. g in. Eave dosure Dripedge High Pro10eTlle MIAMMADECOUNTY 9-1 t 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 cmZ) - 9 (58.1 cmZ) square inch adhesive contact with the underside of the file at the head of the tile. Continue in same manner. NOA No.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 10 of 11 ADHESIVE PLACEMENT DETAIL TWO PIECE BARREL 11 Place enough adhesive to achieve 65 to 70 sq. in. Steep pitch applications In contact with the pan tile. when required) 2) Turn coven upside down. Place adhesive in to 1 in. from outside edge of cover tile. Then install the tile. Ensure 20 to 25sciAn.cuntactarea. Underlayment (- Sheathing Five closure (motarshown) weephole Fascia Board Remove top portion of the gave course cover tile. Abut to second course of pan tiles. Ensure eave and of pan and cover tiles are Rush at save line. Two Piece Barrel -High Profile Tile Two Piece Barrel (Cap and Pan) Tile 1. Starting at the eave course, apply a minimum 2" (50.8 mm) x 10" (254 mm) x 1" (25.4 mm) foam paddy onto the underlayment positioned as shown under two adjacent pan tiles. Support eave tiles from rocking until adhesive has a chance to cure. 2. Continue in same manner bringing two pan courses up toward the ridge. Insure approximately 65 (419.4 cm) — 70 (451.6 cm2) square inch adhesive contact with the underside of the pan tile. Turn covers upside down exposing the underside of the tile. Apply a minimum I" (25.4 mm) x 10" (254 mm) bead of adhesive directly on the inner edge of each side of the cover rile. Leave approximately 3/4" (19 mm) to 1" (25.4 mm) from the outside edge of the tile, inward, 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 riles are considered optional. 5. When additional nailing is required, 2" (50.8 mm) x 4" (101.6 mm) milers or the tie wire system using galvanized, stainless steel, or copper wire and compatible nails may be used. END OF THIS ACCEPTANCE NOA No.: 22-0411.02 Expiration Date: 05/10/27 Approval Date: 05/05/22 Page 11 of 11 Miami Shores Village - BUILDING DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33138 305-795-2204 www.msvfl.qov SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS R4402.13.1 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. 1. .:V 7 Aesthetics -Workmanship: the workmanship provisions of Section R4402 are for the purpose of providing that the roof system meets the wind resistance and water instruction performance standards. Aesthetics (appearance) are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. -,�32 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). 3. _Common roofs: Common roofs are those which have no visible delineation between neighboring units (i.e., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing to be performed. 4. Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetration of the underside of the decking may not be acceptable. This provides the option of maintaining the appearance. 5._Ponding water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low-lying areas of the roof. Pounding can be an indication of structural distress and may require the review of a professional structural engineer. Pounding may shorten the life expectancy and performance of the new roofing system. Pounding conditions may not be evident until the original roofing system is removed. Pounding conditions should be corrected. RevOI 142021 Owners roofing consideration Page 1 of 2 Miami Shores Village - BUILDING DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33138 305-795-2204 www.msvfl.qov 6. -,� D 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. —ID—Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structure assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. (e 12_ Owner ge 's Signature Date ContractorSignatureDate For Forms and Applications click here: http://bldg.miamishoresvillage.com/WebLink/Browse.aspx?id=118080&dbid=0&repo=Mia miShoresVillage ReV01142021 Owners roofing consideration Page 2 of 2 Ron DeSantis, Governor Halsey Beshears, Secretary Florida STATE OF FLORIDA d pr DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD THE ROOFING CONTRACTOR HEREIN IS CERTIFIED UNDER THE PROVISIONS OF CHAPTER 489, FLORIDA STATUTES PRIETO, MAYRELIS MASTER ROOFING, INC 18400 NW 62ND AVENUE 205 HIALEAH FL 33015 LICENSE NUMBER: CCC1330820 EXPIRATION DATE: AUGUST 31, 2022 Always verify licenses online at MyFloridaLicense.com Do not alter this document in any form. This is your license. It is unlawful for anyone other than the licensee to use this document. ❑� i'r at Local Business Tax Receipt Miami -Dade County, State of Florida -THIS IS NOT A BILL -DO NOT PAY 7239287 LBT BUSINESS NAMFARG11oN RECE]"NU. EXPIRES MASTER ROOFING INC RENEWAL SEPTEMBER 30, 2022 18400 NW 62 AVE APT 205 7525387 Must be displayed at place of business H IALEAH FL 33015 Pursuant to County Code Chapter BA- Art. 9&10 - o- OYYNER SEC.TYPEeEaUSINESS MASTER ROOHNG INC 196 SPECIALTY BUILDING CONTRACTOR Whist eECENEU C/O MAYREUS PRIETO CCC1330820 BYTAXCaBECIea $75.00 09/26/2021 Worker(s) i INT-21-394479 This Local Business Tam Receipt only confirms payment of the Local Business Tax The Receipt Is not license, permit or a certification of the M1oMer s yoellfieagans, to de business. Holder mug comply with any governmental or mngovemmental regulatorylaws and requirements which apply to the bonuses. The RECEIPT NO. above months displayed on all commercial vehicles -Miami-Dade Code Sac b-276. Formats fidormotion,viait vvwwmiamitlatla.aevAaacellector ACORU® CERTIFICATE OF LIABILITY INSURANCE `.. DATE(MM1DDlYYYY) 6/23/2022 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 endorsements . PRODUCER CONTANAME: SHILING & TOLEDO INSURANCE INC PHONE 305 823-3881 AI No): 305 823-4383 SHILING & TOLEDO INSURANCE INC E-MAIL DDRE s, Shilin Toledo sntinsurance.com PO Box 651371 INSURERS AFFORDING COVERAGE NAIC # Miami, FL 33265 INSURER A: Western World Insurance INSURED Master Roofing Inc INSURER B : INSURER C INSURER D : INSURER E : 5030 SW 170 AVE INSURER F : Southwest Ranches FL 33331 FL 33331 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INTR TYPE OF INSURANCE a= wyn SUER POLICY NUMBER POLICY EFF POLICY LIMITS A X COMMERCIAL GENERAL LIABILITY FV__1 CLAIMS -MADE OCCUR NPP8700111 4/22/2022 4/22/2023 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES occurrence) Ea oecuence $ 100,000 MED EXP (Any one person S 5,000 PERSONAL & ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY EC LOC OTHER: GENERAL AGGREGATE $ 11000,000 PRODUCTS -COMP/OP AGG $ 1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY NIA COMBINED SINGLE LIMIT accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE NIA EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFtCER/MEMBER EXCLUDED? El (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N 1 A NIA PER OTH STATUTE I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT $ NIA DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) CCC1330820; Roofing Contractor CERTIFICATE HOLDER CANCELLATION Miami Shores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2nd Ave THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Miami Shores, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD AC40 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY) 06/16/2022 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 (les) 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 FrankCrum Insurance Agency, Inc. 100 South Missouri Avenue Clearwater FL 33756 CONTACT NAME: PHONE A C No, Ext : 800 277-1620 X 4800 FAX (AIC, No): 27 787-0704 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Frank Winston Crum Insurance Company 11600 INSURED FrankCrum UC/F Master Roofing, Inc. 100 South Missouri Avenue Clearwater FL 33756 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER_ HUBHZU REVISION NUMBER' 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 LTR TYPE OF INSURANCE ADDL INSRD SUBR WVO POLICY NUMBER POLICY EFF (MM100NYYY) POLICY EXP (MUMONYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE f CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea oxwrenco f MED EXP (Any one person) f PERSONAL 3 ADV INJURY f LIMITAPPLIES PER: GENERAL AGGREGATE f GEN%AGGREGATE PRODUCTS-COMPIOP AGG f POLICY F] PROJECT F__1 LOC f OTHER: AUTOMOBILE LIABILITY COMBINErD SINGLE LIMIT f BODILY INJURY $ ANY AUTO OWNED AUTOS SCHEDULED ONLY AUTOS BODILY INJURY (Per aocklml) $ PROPERTY DAMAGE ao�dersl f HIRED AUTOS NON -OWNED ONLY AUTOS ONLY(per S UMBRELLA LRB ICLAJMIS-MADE OCCUR EACH OCCURENCE S AGGREGATE f EXCESS LIAR DEO I I RETENTION f f A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N WC202200000 01 /01 /2022 01101 /2023 X PER STATUTE O ER E.L. EACH ACCIDENT $1,000,000 ANY PROPRIETORIPARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NN) If yos, describe under E.L. DISEASE -EA EMPLOYEE ft 000 00D DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT t 000 000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached If more space Is required) Effective 04/27/2020, coverage is for 100% of the employees of FrankCrum leased to Master Roofing, Inc. (Client) for whom the client is reporting hours to FrankCrum. Coverage is not extended to statutory employees. rIWvTWIVAT� Knr n�a UALMUrLi_AIruN 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 Miami Shores Village Bldg Dept. 10050 NE 2nd Avenue. Miami Shores, FL 33138 01988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 _ucation Address 436 NE 94TH ST, Miami Shores, FL 33138 Issue Date: 11/23/2022 Parcel Number 1132060140340 Permit NO.: REV-08-22-2005 Permit Type: Revision Work Classification: Roofing Permit Status: Applied Expiration: 05/23/2023 Contacts JASON DOMARK Owner MASTER ROOFING INC Contractor MAYRELIS PRIETO Other: 3057267147 Mobile: 7862025536 MAYRE1989@GMAIL.COM Description: CHANGE IN TILE FROM VILLA 900 GOLD DUST TO �: Valuation: $ 35,000.00 Inspection Requests: EAGLE TILE CAPISTRANO COLOR VIERA BLEND 305-762-4949 Total Sq Feet: 3,000.00 Fees L$60.00 nt Payments Date Paid Amt Paid Revision: Minor Change of Plans Total Fees $60.00 Total: 0 Cash 11/23/2022 $60.00 Amount Due: $0.00 .: adding Department Copy ;;,:,. jeration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations ri,00ing thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores -Ilage. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co"truction and zoning. Futhermore, 1 authorize the above named contractor to do the work stated. Owner / s FY'I / Contractor Agent 23/Z�Z- November 23, 2022 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 ENTERED AUG 08 BY: FBC 20ZO -1� BUILDING Master Permit No. AF -06-2Z-160fo PERMIT APPLICATION Sub Permit NO. eEV-00`ZZ -2W5 F—IBUILDING ELECTRIC ZOOFING [dREVISION Ej EXTENSION RENEWAL PLUMBING MECHANICAL CHANGE OF CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: q-b& 06 R4 51 City: Miami Shores County: Miami Dade zip: 3-5138 Folio/Parcel#: 113ZO& 014 03ND Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 0v\ DO L ' &,f k, Phone#: 305 3L(o Address: 143& NC 949i City: kta..h; hkvrut) State: r—L zip: 33/39 Tenant/Lessee Name: Phone#: 305' ?26 �,i4j'k Email: wv✓t CONTRACTOR: Company Name: Address: 563c hw Email: k"�U Qualifier Name: State Certification or Registration #: UZ 13308 Z�Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: > � s Address: City: State: _Zip: Value of Work for this Permit: $ '56 00 0 Square/Linear Footage of Work: 'Zoot Tvpe of Work: ❑ Addition ❑ Alteration ❑ New L_Iv Repair/Replace ❑ Demolition Specify color of color thru Submittal Fee Scanning Fee $ Technology Fee Structural Reviews $ Permit Fee $ DCA Fee $ Training/Education Fee $ CCF $ CO/CC $ DBPR $ Notary $ Double Fee $ P&Z Review $ Bond $ TOTAL FEE NOW DUE $ (6' OD (Revised04/05/2022) 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 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 OWNER or AGENT The foregoing instrument was acknowledged before me this S day of 4u-s'f 120 ZZ by To,ovv Qo wc h who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: xaL ( Print: 4 Seal: t IIII APPROVED BY as Signature 44A CONTRACTOR The foregoing instrument was acknowledged before me this S day of t,u3 20 2Z, , by fyiQ,rl S I�ri �—'�'O who is personally known to me or who has produced as identification and who did take an oat NOTARY PUBLI Print: 1)a ' w I Cl \C, \W --! Seal: '6 ' JACOUiLINE LOPEZ of Florida s°: •a Oomm(ssion k fili 080830 Expires Feb.:r:y 24, 2025 >n`,offlepA Bwded Tire Budget N0u7Sffvt= Plans Examiner Zoning (Revised04/05/2022) Structural Review Clerk