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RF-10-1248BUILDING PERMIT APPLICATION FBC 2004 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit Type (circle): Building Electrical Plumbing Mechanical Owner's Name (Fee Simple Titleholder) 0,44 ( evy Phone # 7/S -478- 0e Owner' Address /o..2.7 �0 �t7' �� /fob? Cit ( ' 1 State ¢% Zip 33(3P Tenant/Lessee Name Phone # Job Address (where the work is being done) /0.276 /E /Am 4' City Miami Shores Village County Miami -Dade Z FOLIO / PARCEL # `f'® 322 _ ® /9 — 009 Is Building Historically Designated YES NO 1/ Contractor's Company Name ,e2,4i /2 , W//2/ y Value of Work For this Permit $ % 3 v„ Submittal Feel' - Permit Fee $ Notary $ ' Fee $ Scanning $ (Q • 00 Radon $ DPBR $ Phone # Zip Permit No. Master Permit No. ip 33/-31 1:10)Mg1731) BY: 12, �10 -129' • • • • • •• • eeeeee • Roofing •••• •••• • •• • •. •• • 3&s = • •••• •.•• Contractor's Address (J` ,J, 97 5/ CityM4i t .f . (ojer State _ ;17- Qualifier Name riej 2 e ) ( 6EtiOci/t.. Phone # 3&r 7.47:-.. / Z . State Certificate or Registration No. (e e e •• • 35/38 •.'..• • •• • • . • Certificate of Competency No. tOp''J. ' • • •. • • •• Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: 30/4 Type of Work: (Addition QAlteration ['New Repair/Reejn'i ace 0 Demolition Des rite Work: 1444 0 EXu /P/ie ,44/-a rb'rt/eZ '? r1 vC - -Se Sat . -.ts ** * * * *** * ** * * ** ** * * ** * ****** *, *,r **** Fees * * ** * * * ** *** * * ** * * * * ** * * ** ** * * * * * * *** CCF $ 10 ' UV CO /CC Technology Fee $ 14 -4 Zoning $ Bond $ Code Enforcement $ Double Fee $ Structural Review. $ Total Fee Now Due $ 501 See Reverse side —* • • • •.•... • • •••••• • • • • ••••• • •• • • • Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 g88d'fgith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person • �•w propePz5flI subjecj t � attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site • J�: , die firs: iapeetion Ibhicft•occurs seven (7) days after the building permit is issued. I J the absence of such posted notice, the • inspection wzll not be apPPeptl •and a reinspection fee will be charged. • • • • •. a .foregoixtg • •• • tlt4 O f y:: • •• who is perse oWi to me or who has pro ed As identification and who did take an oath. NOTARY PUBLIC: Sign: C 14til aar Print: �� Sen dr a D. ILIA r kommisslon # DD867sSs My Commission Expires: pies: APR. 02, 2U panto m A g A c � MC ***'f(** ** '*'******'* tY'( 1t ***'******* *** *Yk ** *******Ykit7k]ti1k' **** *'1t'********** *ftiik**** APPLICATION APPROVED BY: (Revised 02/08/06) •...•• •• O r car gent Contractor instrument was acknowledged before me this 7 The egoing instrument was acknowledged before me this 7 ••• 200., b Lex day of ►��� ± 20 tb , by artneelja,If � D who • _ - . n. y . own to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: tatititYttbilt Sign: Print: My Commissio * * * * * * * ** WAIIIl ♦t 'ra Plans Examiner Engineer Zoning NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. i/i vo o /7'00 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address. 2. Description of improvement: Signatu = s 0 By Print N =( e Title/Office STATE OF FLORIDA COUNTY OF MIAMI -DADE 129.01 -52 PAWS 3 11107 I - 1 2L-18 . 1111 3. Owner(s) name and addj i Pv Dot Interest in property :AW K /490276 /Ld l .4 0E Name and address of fee simple titleholder. 4. Contractor's name, address and phone number. 5. Surety: (Payment bond required by owner from contractor, if any) Nate, address and phone number ount of bond $ 6 Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provid Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number. vQ 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Sect .•`• 713.13(1)(b), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is s WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CO IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCI OR RECORDING YOUR NOTICE OF COMMENCEMENT. r(s)' Authorized Officer/Director/Partner/Manager The fo = • oin instrument was acknowledged before me this , day of By Pi JW ❑ J$'dividually, or C3 as for Personally known, or ❑ produced the following type of identificati Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under Penalties of perjury, I declare that I have read the foregoing and that-the facts stated in it are true, to the best of my knowledge and belief. Signature(s) of Owner(s) or Owner(s)'s Authorized Officer/Director/Partner/Manager • B y By Print Name Title /Office who signed above: :>FN 2i e10R045 x'081! OR @k 27345 P9 3851f t f p s RECORDED 07/08/2010 13 :25:25 HARVEY MIN, C : LERK. OF COURT MIAMI -C +ACHE COUNTY, FLORIDA LAST PAGE Space above reserved for use of recording office Sandra D. Hart :Commission 4 aspires: A19.0Z213 Did VOW ATLAIWICarnann 0011.1 T -1 14 LFL 3,42N j t FLAT ROOF Passe • / Inspector Comments CREATED AS REINSPECTION FOR INSP- 151089. CREATED AS REINSPECTION FOR INSP- 148086. Counter flashing must be attached properly and sealed. NB ec ® Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid until Inspection Number: INSP - 151230 Inspection Date: September 16, 2010 Inspector: Bruhn, Norman Owner: LEVY, RAPHAEL Job Address: 10276 NE 12 Avenue Miami Shores, FL 33138- Project: <NONE> Building Department Comments September 17, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Contractor: OBENOUR ROOFING SHEET METAL & SUPPLY CO. INC For Inspections please call: (305)762 -4949 Permit Number: RF-7 -10 -1248 I Per4nit Type: Roof Inspection Ty e: Final Roof Work Clas ification: Fiat Phone Number 305/758 -9065 Parcel Number • Phone: 305 - 757 -2612 Page 1 of 1 INSPECTION AFFIDAVIT es 'I`) O b en a v t/ licensed as a (n) Contractor / Engineer / Architect, License #: On or about g / c 2 1 // U (Date & time) Secondary water barrier work at / 0 - 7 I: Sign (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) State of Florida County of Dade: The undersigned, being the first duly swom, deposes and says that he /she is the contractor for the above property mentioned. Swom to and subscribed before me this Notary Public, Sate of Florida at Large *General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with permit # and address # clearly shown marked on the deck for each inspection Revised on 5/21/2009 RE: Permit # 1 -t D 1 0 4 ) / (Print name and circle License Type) cc O(' 3 c��- FS 468 Building Inspector , I did personally inspect the roof deck nailing and e /fit - day of t; 5 1 ¢ C L VIOTAIT NMI IC. MATZ; 01 01 , t , Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: I b Owner's Notification Fonn 07 "Delivering Excellence Every Day" � . .BLDG S'I4N 1 i� �L B1 j am , HIGH VELOCITY HURRICANE ZO ES- REQUIRE , 0 i :— • OR ROOFING CONSIDE S BJ [iCT i C , P I_IA CE IT 1524.1 Scope. As it pertains to thi section, it is me respons o r roo ng contractor to provide the owner with the required roofing permit, and *lain th s section. The provisions of Chapter 15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for roofmg system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the designated space indicates th l the item has been explained. . Aesthetics - workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane • ne) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion 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. . Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be riled in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing ropf system)'....• e'4 3. Common roofs: Common roofs are those which have no visible deli i.e. townhouses, condominiums, etc.). In buildings with common roofs, the owner should notify the occupants of adjacent units of roofing work to be perfo►dr 7 1 .; 4. Exposed ceilings: Exposed, open beam ceilings are where the und g can be.:. om below. The owner may wish to maintain the architectural appear .+' e• t " '�r o i • nail penetrations of the underside of the decking may not be acceptable. The owner `6 y_ id ti o • • • • maintaining this appearance. 5. Ponding water: The current roof system and/or deck of the building may not drain well and may e ater to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofmg system. Ponding conditions may not be evident until the original roofing system is removed. Ponding conditions should be corrected. MIAMI COUNTY Property Address: I 42276 A/ �PPO��FD BY ZGNING DEPT 2 a • • boring• • %• and/or • • •• • • • • 6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not rierloaded from a build up of water. Perimeter /edge walls or other roof extensions 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: Chapter 15 and 16 herein and the Florida Building Code, Plumbing. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the in of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. Exception: Attic spaces, designed by a Florida- licensed engineer or registered architect to eliminate the attic venting, venting shall not be required. Owner's /Agent's Signature: Date: / Contractor's Signature: Permit Number: z OWNER'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE - BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PURSUANT TO SECTION 553.844 F.S. Miami Shoresyillage Bldg. Dept. 10050 N.E.-2nd. Avenue Miami FL. 33138 Re: Owner's Name / Q levy Property Address " /42. 74. /114 4Z 4-1'E /nij/ Selo AI'S ycZ- 3 3 / 3 Roofing Permit Number To: Dear Building Official: I to Lel hvi con ectons of my buildi because: i ature of Prope Owne ' 41) 01Jhvy Print /Name STATE OF FLORIDA COUNTY OF MIAMI -D DE Sworn to and subscribed before me this day of ___ : ,20 10 , (SEAL) I Personally known or Produced Identification 1I 1,10TATT UP KORADA Sandra D. dart Commission DD867559 APR, 02,2013 certify that I am not required to retrofit the row to • wall • • ...• • • • •• • The just valuation for the structure for purposes of ad valorem taxation in le t ian $300 Q • • . • • .. • The building was constructed in compliance with the provisions of the Flofida'Building • bode (FBC) or with the provisions of the 1994 edition of the South Florida $tzildipg Code X1994 SFBC). • • . • • •• •• • .•• • •. .. • .• .. • • When the just valuation of the structure for purposes of ad valorem taxation is equal to or more than $300,000.00, and the building was not constructed in compliance with the FBC nor with 1994 SFBC, and affidavit of Roof to Wall Connection Hurricane Mitigation Retrofit must be provided. C.1Dowmmnt. and Selmg+Yto 11Mv DootmpumLSimitaiasOmpha 2Viaofng AOSdavit Campliama- 92607Fi1Wda.daa • • • • • • • • • • • • Primary Zone: 1400 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 3/2 Floors: 1 Living Units: 1 Adj Sq Footage: 2,479 Lot Size: 12,220 SQ FT Year Built: 1949 $50,000/ $395,420 5 53 42 MIAMI SHORES City: SEC 8 REV PB 43 -67 Legal LOT 2 BLK 175 LOT Description: SIZE IRREGULAR OR 20480 -4430 06 2002 1 COC 24921 -4992 08 2006 1 Year: 2009 2008 10276 NE 12 AVE Applied Applied Taxing Authority: Exemption / Taxable Exemption/ "Taxable 10276 NE 12 AVE MIAMI Value: Value: Regional: $50,000/ $395,420 $50,000/ $568,841 County: $50,000/ $395,420 $50,000/ $568,841 City: $50,000/ $395,420 $50,000/ $568,841 School Board: $25,000/ $420,420 $25,000/ $593,841 Folio No.: 11 - 3205 - 019 - 0020 Property: 10276 NE 12 AVE Mailing RAPHAEL LEVY Address: 4 _$+ ?31,382 $329,713 10276 NE 12 AVE MIAMI $445,420 SHORES FL Assessed Value: 33138 -2633 Year: 2009 2008 Land Value: $214,038 $289,128 Building Value: _$+ ?31,382 $329,713 Market Value: $445,420 $618,841 Assessed Value: $445,420 $618,841 Miami -fade My Home My Home miairiidade. + o Show Me: !Property Information Search By: Select Item Text only Property Appraiser Tax Estimator Property Appraiser Tax Comparison Portability S.O.H. Calculator Summary Details: Property Information: Assessment Information: Exemption Information: Taxable Value Information: Sale Information: Ic�im fl + luronna ACTIVE TOOL: SELECT Aerial Photography - 2009 Web Site ® 2002 Miami -Dade County. All rights reserved. 0 My Home 1 Property Information I Property Taxes 1 My Neighborhood !Property Appraiser Home 1 Using Our Site 1 Phone Directory 'Privacy 1 Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. y16}t••• • • • • • • • • • • •• • Page 1 of 2 Legend Property Boundary Selected Property N Street ,+/ Highway Miami -Dade County . Water • ••• • • • • • •• •••• • • •••• • • • • •• • • • • •• • • • •••• • • • http: / /gisims2. miamidade .gov /myhome /propmap.asp 6/4/2010 • • • • •• • • • • 2009 2008 $25,000 $25,000 +nd Ho u ad: YES Miami -fade My Home My Home miairiidade. + o Show Me: !Property Information Search By: Select Item Text only Property Appraiser Tax Estimator Property Appraiser Tax Comparison Portability S.O.H. Calculator Summary Details: Property Information: Assessment Information: Exemption Information: Taxable Value Information: Sale Information: Ic�im fl + luronna ACTIVE TOOL: SELECT Aerial Photography - 2009 Web Site ® 2002 Miami -Dade County. All rights reserved. 0 My Home 1 Property Information I Property Taxes 1 My Neighborhood !Property Appraiser Home 1 Using Our Site 1 Phone Directory 'Privacy 1 Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. y16}t••• • • • • • • • • • • •• • Page 1 of 2 Legend Property Boundary Selected Property N Street ,+/ Highway Miami -Dade County . Water • ••• • • • • • •• •••• • • •••• • • • • •• • • • • •• • • • •••• • • • http: / /gisims2. miamidade .gov /myhome /propmap.asp 6/4/2010 • • • • •• • • • • CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self - performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: PERMIT # A DD RESS: log "RI 1ug lot FOLIO NUMBER: r I 3 0 1 O D (9 — ©b 1 b FLOOD ZONE: 13 1S FLOOD ELEVATION: FREEBOARD: COST OF PAST IMPROVEMENTS (12 MONTHS): CO `;T OF PROPOSED IMPROVEMENTS: (ATTACH COPY OF CONTRACT) ii, 3'-0 TOTA L CUMULATIVE COST OF IMPROVEMENTS (past and proposed): VA LUE OF PRINCIPAL STRUCTURE (attach appraisal): OWNERS SIGNATURE: PLA Ni REVIEWER: PLAN REVIEWER SIGNATURE: • • • -- •. • ..••.• • •• • •• .• EAST OF Fi2VC'CL: • • • • • • •• • • • • • •..••. • • • • • • • • •• •• • DATE: DATE: •. • • • . • •••• • •.•• • • I7,3./Q 0 • • • 000000 • • • • • • • • • • t Roof System Required Sections of the Permit Application Form Attachments Required See List Below Low Slope Application A, B, C 1,2,3,4,5,6,7 Prescriptive BUR RAS 150 A, B,C 4,5,6,7 Asphaltic Shingles A, B, D 1,2,4,5,6,7 Concrete or Clay Tile A, 8, D, E 1,2,3,4,5,6,7 Metal Roofs A, B, D 1,2,3,4,5,6,7 Wood Shingles and Shakes A, B, D 1,2,4,5,6,7 , Other As Applicable 1,2,3,4,5,6,7 - . • • High Velocity Hurricane Zone Uniform Roofing Permit Application Form MIAMI -DADE COUNTY BUILDING DEPARTMENT ELECTRONIC APPUCATION INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPUCATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW. ATTACHMENTS REQUIRED 1. Fire Directory Listing Page 2. From the Miami -Dade County Notice of Acceptance i NOA Cover Sheet ► NOA Specific System Description ► NOA Specific System Limitations ► NOA General Limitations ► Applicable Detail Drawings Any other additional data reasonably required by the Building Official to determine the integrity of the roofing system. Page 1 •••• • • •••• •• •• •• • • • • • • • • • •• • 3. Design Calculations per Chapter 16, or if applicable, RAS 127 or RAS 128 4. Other Component Notice of Acceptances • 5. , Municipal Permit Application 6. .Owners Notification for Roofing Considerations (Appendix " F" Form) Re- roofing or Repairs Only 7. Any Required Roof Testing/Calculation Documentation Page 1 of 1 ••• • •••• •• • •• • • • • • ••• •• • • • • •• • • • • •••• • • •••• • • • • 'E -Codes ❑ New Roof ,kr Low Slope ❑ Asphaltic Shingles Low Slope Roof Area (SF) Florida Building Code Edition 2004 High- Velocity Hurricane Zone Uniform Permit Application Form. Section A (General Information) Master Permit No. Process No. contractor's Name Obc4/©4%4 RO, L /f+VV Job Address / 1, 7/ Air /2 MVi ROOF CATEGORY O Mechanically Fastened Tile D Metal Panel/Shingles D Prescriptive BUR -RAS 150 ROOF TYPE eroofing 0 Recovering ROOF SYSTEM INFORMATION Steep Sloped Root Area (SF) D Mortar/Adhesive Sot Tile D Wood Shingles/Shakes ❑ Repair 0 Maintenance •••• • • • •••• • • • • • • • • Totals$} : • S ection B (Roof Plan) • • Sketch Roof Plan: illustrate all levels and sections, root drains, scuppers, overflow scuppirra overf v • rains Include dimensions of sections and levels, clearly Identify dimensions of elevated pressrtrf§ 'elites and Toonton of parapets. • • • • • e • . • • • • • • • • IAhIiuuIIIIIIlIuIIIuiiirui 1111 1 1 111 • • • • • • • • Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form Section C (Low Sloped Roof System) Fill in Specific Roof Assembly Components and identify Manufacturer (if a component Is not used, identify as "NA") System Manufacturer: r , NOA No.: 07-Al l q, d . Design Wind Pressures, From RAS 128 or Calculations: Pmax1: 52 Pmax2: g/ 3 Pmax3: /3" Max. Design Pressure From the Specific NOA System Dedc Type: at d/ Slope• 4 Gauge/Thickness: Anchor/Base Sheet & No. of Ply(s)• &rear 7,i' Andro r Skeet F �� tBapdin9 Material: fr Insulation Base Layer. , 1�r+ /.'A , f s Base Insulation Size and Thlc / ✓ mil` Base Insulaion F ner/BoAdi Vi Top insulation Layer. Top Insulation Size and Thldmess: Top Insulation Fast - nding Material: Base Sheet(s) & No. of Ply(s): � �,egfa Besets ster�en Material: Ply Sheet(s) .& No. of Ply(s): T F ,o4 Ply Sheet Fasr/Bo , Mat Il , f �te ° ee � /pct a .(�' Top Ply. G ,,�/aerl e Srt4 Top PijLl Bondiri}t rlal: Surfacng: ltt Fastener Spacing for Anchor/Base Sheet Attachment &f /5 ° Field: " oc @ Lap. # Rows • oc Perimeter. 6 *cm , Lap, # Rows Comer _ oc @ Lap, # Rows e "oc Number of Fa rs Per Insulation Board ,� Field Perimeter Comer illustrate Components Noted and Details as Applicable: Woodblocking, Gutter, Edge Termination, Stripping, Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter- Flashing, Coping, Etc. • • • •••• Indicate: Mean Roof Height, Pyapot HAW Height of Base Flashing, Component Matariej, ; Material Thidmess, Fastener• 8•Ype, Fastener's Spacing or Submit Manufact wews. Details that Comply with RAS 111 and Chaptar•16. •••• • •• • • • • •• • i te a. D ® ? •• ••• 1 • . ?� - �otirc „vc Lv 1 /�rcY�.�iff T' 2 9 /cr g9 , fLalS' /N - - ;(isa 7 f ap FT.• 1/ �as.e �xGP # 42 SQ'd •• •FT. Parapet - Hel8M Mean Roof Height • •• •• • • • Si odu > y� e e 5e • • • • • • • • • • • •••• arc 123_01 -48 12/09 PAGE 3 • • • • • • • • •••• • • •••• •••• • MMI�DADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) GAF Material Corporation 1361 Alps Road Wayne, NJ 07470 MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Product Review Committee 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 Division (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. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division that this product or material fails to meet the requirements oft. applicable building code. •••• • • • • • This product is approved as described herein, and has been designed to comply with the F.f Building' .. Code and the High Velocity Hurricane Zone of the Florida Building Code. • DESCRIPTION: GAF Conventional Built -Up Roof System for Wood Decks. • ••• • • •• NOA No.: 07- 1219.09 Expiration Date: I1/04/i3 Approval Date: 03/20/08 Page 1 of 19 •••• • •• •• • LABELING: Each unit shall bear a permanent label with the manufacturer's name or 1pg0, City, stare. • • • • and following statement: "Miami -Dade County Product Control Approved", unless other/miss noted • herein. • • • RENEWAL of this NOA shall be considered after a renewal application has been filed and thege 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. 03- 0501.05 and consists of pages 1 throygh 19. The submitted documentation was reviewed by Jorge L. Acebo. APPROVED ASSEMBLIES Deck Type 1I: Wood, Insulated Deck Description: 19 / 32 " or greater plywood or wood plank System Type A: Anchor sheet mechanically fastened, all layers of insulation adhered with approved asphalt. All General and System Limitations shall apply. One or more layers of any of the following insulations. Insulation Layer (Table 2) Insulation Fasteners Fastener (When applicable: Steel plate only =S, plastic plate only (Table 3) Density /ft P) EnergyGuardTM, EnergyGuardTM Composite, EverGuard ISO, EnergyGuardTM RA, EnergyGuardTM RA Composite Minimum 1" thick N/A N/A EnergyGuardTM High Density Wood Fiber, EnergyGuardTM Recover Board, Wood Fiber, Minimum' /," thick N/A N/A EnergyGuardTM Perlite Minimum 3 /<" thick N/A N�t4 • • • Fiberglas (Min. I5 /I6 " thick) N/A •••• • • Note: All insulation shall be adhered to the anchor sheet in full mopping of applifiDiot asphalt within the EVT range and at a rate of 20-40 lbs/100 ft Please refer to Roofing A,plication ... • Standard RAS 117 for insulation attachment. Insulation listed as base layer onl'7f be usedionly as base layers with a second layer of approved top layer insulation installed as thermal mend substrate. Composite insulation panels may be used as a top layer placed with the • • polyisocyanurate side facing down. GAF requires either a ply of GAFGLAS S1RN.`1 IVENT ® ' • EliminatorTM Perforated laid dry or a layer of EnergyGuardTM Perlite or wood fiber gverlayltified° on all isocyanurate applications. • •.. • ... • • • •••• Fire Barrier: FireOutTM Fire Barrier Coating, VersaShield ® Non- Asphaltic Fiberglass -Based (optional) Underlayment or SecurockTM. Anchor sheet: GAFGLAS #80 ULTIMATM Base Sheet, STRATAVEN I! EliminatorTM Nailable, RUBBROID Modified Base Sheet, RUBEROID 20, RUBEROID Heat We1dTM Smooth or RUBEROID Heat- WekdFM 25 base sheet mechanically fastened as described below; Fastening Options: GAFGLAS Ply 4, GAFGLAS Flex PIyTM 6, GAFGLAS #75 Base Sheet or any of above Anchor sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the lap staggered and in two rows 12" o.c. in the field. (Maximum Design Pressure -45 psf, See General Limitation #7) NOA No.: 07- 1219.09 Expiration Date: 11 /04 /13 Approval Date: 03/20/08 Page 8 of 19 Fastening Options: Base Sheet: Ply Sheet: GAFGLAS Ply 4, GAFGLAS Flex PIyTM 6, GAFGLAS #75 Base Sheet or any of above Anchor sheets attached to deck with Drill -TecTM # 12 standard, #14 or # 15 Screws and 3" Drill -TecTM steel plate or Drill -TecTM AccuTrac Plates, 12" o.c. in 3 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 12" o.c. in the field of the sheet. (Maximum Design Pressure — 4s psf, See General Limitation #7) GAFGLAS Flex P1yrm 6, GAFGLAS #75 Base Sheet or any of above Anchor sheets attached to deck with approved annular ring shank nails and tin caps at a fastener spacing of 9" o.c. at the 4" lap staggered and in two rows 9" o.c. in the field. (Maximum Design Pressure — 52.5 psf, See General Limitation #7) GAFGLAS #80ULTIMATM, RUBEROID 20, RUBEROID Mop Smooth, base sheet attached to deck with approved 11/4" annular ring shank nails and inverted 3" steel plate at a fastener spacing of 9" o.c. at the 4" lap and in two rows • staggered with a fastener spacing of 9" o.c. in the center of the membrane. (Maximum Design Pressure — 60 psi, See General Limitation #7) GAFGLAS #75 Base Sheet or any of above Anchor sheets attached to deck with Drill -TecTM #12 standard, #14 or # 15 Screws and 3" Drill -TecTM steel plate or Drill -TecTM AccuTrac Plates, 12" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximun, Design Pressure — 60 psi, See General Limitation #7) Any of above Anchor sheets attached to deck approved annular ring shank n&il's' • and 3" inverted Drill -TecTM insulation plates at a fastener spa$ine•of.9" o.: the 4" lap staggered in two rows 9" in the field. • • • • (Maximum Design Pressure — 60 psf, See General Limitation • GAFGLAS #75 Base Sheet or any of above Anchor sheets attar 41 to dectc yritb' Drill- TecTM #12 standard, #14 or # 15 Screws and 3" Drill Ter;: steel plate or • • Drill -TecTM AccuTrac Plates, 8" o.c. in 4 rows. One row is in the 2. side lap± • • • The other rows are equally spaced approximately 9" o.c. in the el:11f the sheet. (Maximum .Design Pressure -7S psf, See General Limitation W 7) • • • • (Optional) Install one ply of GAFGLAS #75, GAFGLAS #8a 4.3L' TSIMAT; • • •' . Base Sheet, GAFGLAS STRATAVENT EliminatorTM Perforated, • RUBEROID Modified Base Sheet, RUBEROID Mop Smooth, RUBEROID® 20 RUBEROID Heat- We1dTM Smooth or RUBEROID Heat- We1dTM directly over the top layer of insulation. Adhere with any approved mopping asphalt applied within the EVT range and at a rate of 20-40 lbs./sq; (see General Limitation #4). One or more plies GAFGLAS PLY 4, GAFGLAS Flex PIyTM 6 sheet, #80 Ultima, RUBEROID Mop Smooth or RUBEROID 20 adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 • lbs./sq. NOA No.: 07- 1219.09 Expiration Date: 11/04/13 Approval Date: 03/20/08 Page 9 of 19 Cap Sheet: Surfacing: Maximum Design Pressure: See Fastening above. PUAMEDeiDECOt1NTY APPROVED (Optional) One ply of GAFGLAS Mineral Surfaced Cap Sheet or GAFGLAS Mineral Surfaced Cap Sheet adhered in a full • mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbsisq. (Optional, required if RUBEROID MOP Smooth or RUBEROID 20 is top membrane) Install one of the following: 1. Gravel or slag applied at 400 lbs. /sq. and 300 lbs./sq. respectively in a flood coat of approved asphalt at 60 lbs./sq. or applied in a flood coat of Leak BusterTM MatrixTM 103 Cold Process Adhesive applied at a rate of 3 gal./sq. 2. GAFGLAS Mineral Surfaced Cap Sheet, GAFGLAS Energy Cap Mineral Surfaced Capsheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbsisq. 3. Leak BusterTM MatrixTM 303 Premium Fibered Aluminum Roof Coating, at 1.5 gal. /sq. 4. Leak BusterTM MatrixT ' 715 , Leak BusterTM Matrix" 322, TOPCOAT MB +, TOPCOAT Fireshield Elastomeric Roofing Membrane, applied at 1 to 1.5 gal. /sq. 5. Leak BusterTM MatrixTM 602 MB Xtra Elastomeric Roofing Membrane, EnergyCote® roof coating applied at 1 to 1.5 gal. /sq. 6. TOPCOAT Surface Seal, TOPCOAT Fireshield SB Solve1 r • • • • based Elastomeric Roofmg Membrane applied at :l to j0.4 gal. /scf '• • 7. Advance Green Technologies Photovoltaic Lan gajj,solar collector auxiliary roof equipment installed in. an apliance with manufacturer's specifications and applicable Buildi Cgdes. • • • • • • •••• •.•• • • •• •• • • • • • • • • • • • • .. • • • • • • • • • • • NOA No.: 07- 1219.09 Expiration Date: 11/04/13 Approval Date: 03/20/08 Page 10 of 19 • • • • • • • • • • • • • WOOD DECK SYSTEM LIMITATIONS: 1 A slip sheet is required with Ply 4 and Flex PIyTM 6 when used as a mechanically fastened base or anchor sheet. 2. Minimum 1/4" Dens DeckTM or Y2" Type X gypsum board is acceptable to be installed directly over the wood deck. GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance, refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20 -40 Ibs./sq., or mechanically attached using the fastening pattern of the top layer 3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt, panel size shall be 4' x 4' maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbssq. Note: Spot attached systems shall be limited to a maximum design pressure off43yst 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Fdree.(F:) value o 27,5 . lbf., as tested in compliance with Testing Application Standard TAS 105. If the fastener value, as fi81 tested, are below 275 lbf insulation attachment shall not be acceptable. • • • • • • 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachmt is bas one minimum fastener resistance value in conjunction with the maximum design value liste•within a s'pbCtfic system. Should the fastener resistance be less than that required, as determined by the 3ta:ling Qtoiah a revised fastener spacing, prepared, signed and sealed by a Florida Registered Engidcrer, architect, oj Registered Roof Consultant may be submitted. Said revised fastener spacing shall uirza be withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in ccynplian$U Witt Roofmg Application Standard RAS 117. • • • • 7. Perimeter and comer areas shall comply with the enhanced uplift pressure requirements of these •di%fts. Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. Calculations prepared, signed and sealed by a Florida registered Professional Engineer, Registered Architect, or Registered Roof Consultant (When this limitation is specifically referred within this NOA, General Limitation #9 will not be applicable.) 8. All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall conform with Roofmg Application Standard RAS 111 and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones (i.e. field, perimeters, and corners). Neither rational analysis, nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (i.e. perimeters, extended corners and corners). (When this limitation is specifically referred within this NOA, General Limitation #7 will not be applicable.) 10. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 9B -72 of the Florida Administrative Code. END OF THIS ACCEPTANCE MIAMIOADE OUNTY APPROVED NOA No.: 07- 1219.09 Expiration Date: 11/04/13 Approval Date: 03/20/08 Page 19 of 19 • • • • • • • • • • • • • • • { • D G 192 ROOF COVERING MATERIALS (TEVT) Roofing Systems (TGFU) Continued Base Coat "A -38 Series ", 0.75 gal /sq. Second Base Coat "A -38 Series ", 0.75 gal /sq. Wear Coat "•A -38 Series ", 0.75 gal /sq plus walnut shells at 0.75 lbs per sq. Surfacing: "A -38 Series ", 0.75 gal /sq plus walnut shells at 0.75 lbs per sq. 46 Deck: NC Incline: 3/4 Foam: Spray application of 2 -in. thick "Polyfoam 273" (2.7 lb /f1. ) Surfacing. Spray application of 28 to 34 -mils "U -8730" (aluminum) 47 Deck NC Incline: 1/2 Insulation: Spray application of 2 -in. thick "Polyfoam 273" (2.7 Ib /ft. Surfacing: Spray application of 28 to 34 -mils "U -8782" (ivory) GAF MATERIALS CORP R1306 1361 ALPS RD, WAYNE Nj 07470 " Ruberoid 20" or " Ruberoid Modified Base Sheet" may be utilized as an alternate to Type G2 base sheets in any of the following Classifications. 1/2 in. thick (min) gypsum board or 1/4 in. thick (min) G -P Gypsum DensDeck® may be used in any existing noncombustible deck Classification. When this is done, the resulting roofing system is acceptable for use over combustible (15/32 in. min) roof decks. The joints in the gypsum board and overlayment board are offset 6 in. with the joints in the deck. If polystyrene is part of the roof system, it must be placed below the overlayment board. Also, multiple plies of " GAFGLAS Ply 4" or "Ply 6" may be adhered to G -P Gypsum DensDeck® in hot asphalt. "EnergyGuard Ultra" is an acceptable alternate to "EnergyGuard" in any applicable Classification. GAF Stratavent Eliminator Venting Base Sheet ( Nailable)" may be mechani- cally attached or hot mopped over noncombustible decks and as a recover over existing roof systems. GAFGLAS Perlite Insulation may be utilized as a cover board over "EVER - GUARD" insulation in any of the following systems. Unless otherwise indicated, the roof insulation is mechanically fastened, adhered with hot mopping asphalt or urethane insulation adhesive. Pol ty rene reference in any of the following Classficatons include "ENERGuard EPS Insulation ". References to glass fiber insulation include "EnergyGuard Fiberglass Insu- lation". ASPHALT FELT SYSTEMS WITH HOT ROOFING ASPHALT "GA Type G2 asphalt glass mat base sheet ': GAFGLAS #75 Base Sheet" or FGLAS #80 ULTIMA" ) is a suitable. alternate for Type GI asphalt glass fiber ply sheet ( "GAFGLAS PIy 4" or " GAFGLAS Ply 6" ) in the Class A, 13 or C roof systems indicated below. The roof deck may first be covered with a Type G2 asphalt glass mat base sheet "GAF Stratavent Eliminator Venting Base Sheet (Perforated)" or "GAF Stratavent Eliminator Venting Base Sheet (Nailable)" . Perforated to be mopped and nailable to be mechanically attached granule side down. As an option Type G2 asphalt glass mat base sheet ( "GAFGLAS #75 Base Sheet ", " GAFGLAS #80 ULTIMA" or "GAF Stratavent Eliminator Venting Base Sheet (Nailable)" may be substituted for GI asphalt glass fiber ly sheet ( "GAFGLAS Ply 4" or "GAFGLAS Ply 6 ") as the nailed base ply in the following systems. Bottom ply or base sheet may be solid mopped, spot mopped or mechani- cally fastened. Unless otherwise indicated, all insulations may be hot mopped or mechani- cally fastened. "GAFGLAS Flashing" or " Ruberoid" may be used for flashing in any of the Class A, B or C systems listed below. When "perlite" is referenced, this includes " GAFTEMP PERMALITE ®" or any other UL Classified perlite insulation. Crushed stone or slag are suitable alternates for gravel in any of the Class A, •, B or C systems listed. Structural cement fiber building units are considered suitable to be included as a deck in the following Class A, B or C systems listed over C -15/32 or NC. The use of gypsum board under any of the following Class A, B or C systems does not adversely effect the rating. The use of 1/2 in. min gypsum board is an acceptable alternate for insulation over C -15/32 decks. The use of polystyrene insulation board between min 3/4 in. perlite board and deck with rosin paper (perlite /rosin paper /polystyrene /perlite) is a suitable alternate for isocyanurate board in the following Class A, B or C systems. "BMCA EnergyGuard RA ", "BMCA Tapered EnergyGuard RA" and "BMCA EnergyGuard RA" may be substituted for any Atlas polyisocyanurate insula- tion in any of the following Classifications. Trumbull "Perms Mop" may be utilized with any of the following "Asphalt Felt Systems with Hot Roofing Asphalt". GAFGLAS #80 Premium Base Sheet may be used in any of the following systems. "GAFGLAS Flex Ply 6" is a suitable alternate to "GAFGLAS Ply 6 ". 2007 ROOFING MATERIALS AND SYSTEMS DIRECTORY LOOK FOR THE UL MARK ON PRODUCT ROOF COVERING MATERIALS (TENT) Roofing Systems (TGFU) Continued "GAFTEMP Permalite Recover Board" may be used in lieu of any perlite insulation in any of the following. NC Classifications. Unless otherwise indicated, any of the "Asphalt Felt Systems with Hot Roofing Asphalt" may be surfaced with "Fireshield MB" at 2.5 — 3.0 gal /sq. Class A, B and C Hot roofing asphalt, for use with organic and glass felts or modified bitumen membranes. "Ruberoid Heat Weld" SBS roofing membrane may be used in lieu of "Ruberoid Mop" SBS products in any applicable Classification. Class A 1. Deck: C -15/32 Incline: 3 Insulation (Optional): One or more layers perlite, wood fiber, glass fiber, isocyanurate, urethane, perlite /isocyanurate composite, perlite/ urethane composite, wood fiber /isocyanurate composite, phenolic, any thickness. Ply Sheet Three or more layers Type G1 "GAFGLAS Ply 4" or "GAFGLAS Ply 6 ", hot mopped. Surfacing: Gravel. 2. Deck: C -15/32 Incline: 2 Insulation (Optional): 1 One or more layers perlite, wood fiber, glass fiber, isocyanurate, urethane, perlite /isocyanurate composite, perlite/ urethane composite, wood fiber /isocyanurate composite, phenolic, any thickness. Ply Sheet: Three or more layers Type Gl " GAFGLAS Ply 4" or "GAFGLAS Ply 6 ". Cap Sheet: One layer Type G3 "GAFGLAS Mineral Surfaced Cap Sheet" or "EnergyCap Mineral Surfaced Cap Sheet ". 3. Deck: NC Incline: 2 Insulation (Optional): One or more layers perlite, wood fiber, glass fiber, isocyanurate, urethane, perlite /isocyanurate composite, perlite/ urethane composite, wood fiber /isocyanurate composite, phenolic, 2 in. max. • • Ply Sheet Two or more layer Ty "GAPGCAS Ply 4" drf' GLAS Ply 6 ". • • • ••• • • Cap Sheet One layer Type i G3; c Minirrtal Surfaced. Cs? Shee" or "EnergyCap Mineral %i tie4l Cap Sheet: • 4. Deck: NC Incline: 112 Insulation: One or two layers e l i Mot?iorm R",41 u . • marl, hot mo Ply Sheet Any UL Classified gPaeelSurfaced Ct9 • A • asphalt g?a mat system. • • • 5. Deck: C -15/32 • • • • • Incine 1• • • • • Slip Sheet (Optional): Red roisytLgar, nailed to deck. • • Base Sheet One layer Type 2 " CAtGLAS 1175 Bade Sheet" jr yI nailed). Ply Sheet One or more layers:'ypegl, "GAFGLAS Ply 4" or G Ply 6". •• • •••• • Cap Sheet: One layer Type G3 " GAFGLA. 1liiaeral Surfaced Cap Sheet" or "EnergyCap Mineral Surfaced Cap Sheet ". 6. Deck: NC Incline: 3 Base Sheet One layer Type G2 "GAFGLAS #75 Base Sheet ". Ply Sheet One or more layers Type Gl " GAFGLAS Ply 4" or "GAF - GLAS Ply 6 ". Cap Sheet: One layer Type G3 "GAFGLAS Mineral Surfaced Cap Sheet" or "EnergyCap Mineral Surfaced Cap Sheet ". 7. Deck: C -15/32 Incline: 2 Insulation: One or more layers perlite, glass fiber, isocyanurate, ure- thane, perlite / isocyanurate composite, perlite /urethane composite, phe- nolic, 1.0 in. min (offset from plywood joints 6 in.). Base Sheet One or more layers Type GI, G2' or G3. Membrane: One or more layers " Ruberoid Torch" (Smooth or Granule) " Ruberoid Torch Plus" (granule), "Ruberoid Mop" (Smooth or Granule or "Ruberoid Mop Plus" (granule). Cap Sheet: Type G3 " GAFGLAS Mineral Surfaced Cap Sheet" "EnergyCap Mineral Surfaced Cap Sheet ", hot mopped. 8. Deck: C -15/32 Incline: 2 Insulation (Optional): One or more layers perlite, wood fiber, fiber, isocyanurate, urethane, perlite / isocyanurate composite, perlite urethane composite, wood fiber / isocyanurate composite, phenolic, a thickness. Base Sheet Two or more layers Type G2 or G3. Ply Sheet (Optional): One or more layers Type Gl. Membrane: One or more layers " Ruberoid Torch" (Smooth or Granule).' "Ruberoid Torch Plus" (granule), " Ruberoid Mop" (Smooth or Granule or "Ruberoid Mop Plus" (granule). • 7ja TOR inveP . viseoFA Tao, .trryER- • 4, 1Jamm lumoBV. WarrOit: • A cER1IFICATKIW0F. KM-WM WOW' VA4E SEE OTHER SIDE AL R855877 DO NOT FORWARD OBENOUR ROOFING SHEET METAL & SUPPLY CO JAMES D OBENOUR'PRES 159 NE 97 ST MIAMI SHORES FL 33138 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L080713963 LICENSE NBR 07/15/2008 080011403 ;CCC014306 The ROOFING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2010 OBENOUR, JAMES 0 OBENOUR ROOFING SHEET METAL & SUPPLY CO 159 NE 97TH STREET MIAMI SHORES FL 33138 CHARLIE CRIST CHUCK DRAGO GOVERNOR INTERIM SECRETARY DISPLAY AS REQUIRED BY LAW 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSRD TYPE OF INSURANCE DATE (MM /DD /YYYY1 DATE IMM/DD/YYYYy GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000 A CLAIMS MADE X OCCUR FMGA001533 6/1/2010 6 / 1 / 2 011 MED EXP (Any one persons $ EXCLUDED X Per Project w/ prior PERSONAL E ADV INJURY $ 1,000,000 written contract GENERAL AGGREGATE $ 2,000,000 GENII AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X P - LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) Al L OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident/ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY AGG $ EXCESS UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR . CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION X WC STATU- OTH• AND EMPLOYERS' LIABILITY Y / N TORY LIMITS ER ANY PROPRIETORtPARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? 5 L EACH ACCIDENT $ 100,000 (Mandatory in NH) 83036966 10/6/2009 10/6/2010 E.L DISEASE - EA EMPLOYEE $ 100,000 If yes. describe under SPECIAL PROVISIONS below E.L DISEASE • POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS ACORD PRODUCER (954) 943 -5050 FAX: Frank H. Furman, Inc. 1314 East Atlantic Blvd. P. 0. Box 1927 Pompano Beach INSURED Obenour Roofing Sheet Metal & Supply Co 159 NE 97th Street Miami Shores COVERAGES CERTIFICATE HOLDER ACORD 25 (2009101) INS025 (2OOSan CERTIFICATE OF LIABILITY INSURANCE FL 33061 FL 33138 (954)942 -6310 DATE (MMIDDIYYYY) 5/27/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A. First Mercury Insurance Co INSURERS BZ'1dgefield Employers Ins Co INSURER C. INSURER D. INSURER E CANCELLATION NAIC # 10701 City of Miami Shores Village 10050 NE 2nd Ave Miami Shores, FL 33153 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRTAT1VES. •a AUTHORIZED EPRE9ENTATIV1 'j986-209'O13 COR ORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD