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RF-10-875Scheduled Inspection Date: July 01, 2010 Inspector: Bruhn, Norman Owner: SAMMONS, CHARLES Job Address: 600 NE 98 Street Miami Shores, FL 33138 -2472 Project: <NONE> Contractor: DOUBLE DIAMOND CONSTRUCTION INC Building Department Comments June 30, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 147243 Permit Number: RF -5 -10 -875 For Inspections please call: (305)762 -4949 Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile /Flat Phone Number Parcel Number 1132060171840 Phone: (386)847 -8899 Reroof flat and tile Passed 2P Failed Correction Needed Re- lnspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 143609. Provide a renail affidavit Page 17 of 26 S i 22,44-,Ty.7.( License #: C e 17C) ) 0 .5 / Manual (Based - '.844 F.S) ature State of Florida County of Dade: Revised on 5/21/2009 RE: Permit# iZi / (Print name and circle License Type) Notary Public, Sate of Florida at Large INSPECTION AFFIDAVIT *General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S. permit # and address # clearly shown marked on the deck for each inspection M iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: 6/2 licensed as a (n) Contractor / Engineer / Architect, FS 468 Building Inspector On or about ✓r.,. _, 4 , I did personally inspect the roof deck nailing and (Date & time) Secondary water barrier work at 6' OD Al c 9' (9 5 (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit The undersigned, being the first duly swom, deposes and says that he /she is the contractor for the above property mentioned. C 3 -6 5 y 0 _ •� D Swom to and subscribed before me this 9---- day of C • ( — ... iztv to maltesuc1 8n [My. < A" clU Eltotographs of each plane of the roof with f `f` /' / / � ► �► ►1111111 t11s a`` Inspection Number: INSP - 143608 Permit Number: RF -5 -10 -875 Scheduled Inspection Date: June 29, 2010 Inspector: Bruhn, Norman Owner: SAMMONS, CHARLES Job Address: 600 NE 98 Street Miami Shores, FL 33138 -2472 Project <NONE> Contractor: DOUBLE DIAMOND CONSTRUCTION INC Building Department Comments Reroof flat and tile Passed Failed Correction Needed Re- Inspection Fee June 28, 2010 — - - ) /e)FiC ) No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Comments For Inspections please call: (305)762 -4949 Permit Type: Roof Inspection Type: Up Lift Report Work Classification: Tile/Flat Phone Number Parcel Number 1132060171840 Phone: (386)847 -8899 Page 7 of 20 Inspection Number: INSP - 143608 Permit Number: RF -5 -10 -875 Scheduled Inspection Date: June 29, 2010 Inspector: Bruhn, Norman Owner: SAMMONS, CHARLES Job Address: 600 NE 98 Street Project <NONE> Contractor: DOUBLE DIAMOND CONSTRUCTION INC Building Department Comments Reroof flat and tile Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 28, 2010 Miami Shores, FL 33138 -2472 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Roof Inspection Type: Up Lift Report Work Classification: Tile/Flat Phone Number Parcel Number 1132060171840 Phone: (386)847 -8899 Page 7 of 20 June 29, 2010 Project: Dear Sirs; Reileh Engineering Corp. (Consulting Engineer) 2370 S.W. 123 Avenue Miami, Florida 33175 -1174 Tel : 305-823-8008 Fax: 305-823-3300 Double Diamond Construction Miami, Florida ROOF TILE UPLIFT TEST REPORT Residential Home 600 Northeast 98 Street Miami Shores, Florida Information provided by client: Permit Number: Not Provided Date Completion: June 24, 2010 Roofing Contractor: Double Diamond Construction Project Number: 10 -0692 (Testing Laboratory Certificate #06- 0501.15) In accordance with your request and authorization, a representative of Reileh Engineering Corporation completed the Roof Tile Uplift Test at the above referenced project. This testing was performed in general accordance with Roofing Application Standard TAS No.106 -- Standard procedure for field verification of the bonding of mortar or adhesive set tile system and mechanically attached, rigid, discontinuous roof systems. The total of the tested roof surface area was less than 10000 square feet, and the mean height of the roof is less than 40 feet above ground surface. The type of tile used for this project was reported to be Barcelona Roof Tile. This tile was reported to have been foamed in place. At the time of our inspection, the entire area of the roof was examined for loose tiles. Not less than one (1) tile in ten (10) of all components in the field area and one (1) tile in five (5) of all tiles in the perimeter and comer areas were physically examined. A minimum of one (1) test per every two (2) squares in the field, one (1) test per square in the perimeter area ridge caps and (1) in the comer areas were conducted. Based on our test results, we conclude that the installation of the roof tile at the above referenced project meets the test requirement outlined in the above- mentioned protocol. Attached please find a copy of our test report for your review. Reileh Engineering Corporation appreciates the opportunity of assisting you in this project. If you have any questions or if we may be of further assistance, please do not hesitate to contact the unddrsigned. Respectfully submitted; Reileh Engineering Corporation TILE UPLIFT TEST Residential Home 600 Northeast 98 Street Miami Shores, Florida ohamad Sonny Salleh, P.E.49014 Project Manager Reileh Engineering Corporation -- Project Number - 10 -0692 — Page 2 of 6 Test Number Test Load (lbf) Test Status 1 35 Pass 2 35 Pass 3 3 5 Pass 4 3 5 Pass 5 35 Pass 6 35 Pass 7 35 Pass 8 35 Pass 9 35 Pass 10 35 Pass 11 35 Pass 12 35 Pass 13 35 Pass 14 35 Pass 15 35 Pass 16 35 Pass 17 35 Pass 18 35 Pass 19 35 Pass 20 35 Pass 21 35 Pass 22 35 Pass 23 35 Pass 24 35 Pass Report of TILE UPLIFT TEST for Residential Home 600 Northeast 98 Street Miami Shores, Florida Project Number: 10 -0692 Reileh Engineering Corporation — Project Number - 10 -0692 — Page 3 of 6 Test Number Test Load (lbf) Test Status 25 35 Pass 26 35 Pass 27 35 Pass 28 35 Pass Z 35 Pass 30 35 Pass 31 35 Pass 32 35 Pass 33 35 Pass 34 35 Pass 35 35 Pass 36 35 Pass 37 35 Pass 38 35 Pass 39 35 Pass 40 35 Pass 41 35 Pass 42 35 Pass 43 35 Pass 44 35 Pass 45 35 Pass 46 35 Pass 47 35 Pass 48 35 Pass 49 35 Pass 50 35 Pass 51 35 Pass 52 35 Pass 53 35 Pass 54 35 Pass Reileh Engineering Corporation -- Project Number - 10 -0692 - Page 4 of 6 Test Number Test Load (lbf) Test Status 55 35 Pass . 56 35 Pass 57 35 Pass 58 35 Pass 59 35 Pass 60 35 Pass 61 35 Pass 62 35 Pass 63 35 Pass 64 35 Pass 65 35 Pass 66 35 Pass 67 35 Pass 68 35 Pass b 35 Pass 70 35 Pass 71 35 Pass 72 35 Pass 73 35 Pass 74 35 Pass 75 35 Pass 76 35 Pass 77 35 Pass 78 35 Pass 79 35 Pass 80 35 Pass 81 35 Pass 82 35 Pass 83 35 Pass 84 35 Pass Reileh Engineering Corporation -- Project Number - 10 -0692 — Page 5 of 6 Test Number Test Load (ibf) Test Status . 85 35 Pass 86 35 Pass 87 35 Pass 88 35 Pass 89 35 Pass 90 35 Pass 91 35 Pass 92 35 Pass 93 35 Pass 94 35 Pass Reileh Engineering Corporation -- Project Number - 10 -0692 — Page 6 of 6 58 15 14 57 45 75 58 o 74 44 60 75 42 72 59 71 70 61 69 12 II 41 70' 7 47 18 0 80 55 48 81 82 85 19 Z O 50 79 56 51 v 78 52 6 77 15 45 76 62 68 65 94 57 10 9 59` 67 8 7 55 64 24 66 8 51 87 55 5 0 65 95 0 92 89 4 59 bq 56 6f 2 88 86 90 6 55 92 0 PIl7GE CAP h51' LOCATION 70' 10 - 06 APPPDX, ROOP Th51' ILOCA110N5 M11717IMN510N5 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 ED Expiration: 11/1512010 Parcel Number Applicant 600 NE 98 Street Miami Shores, FL 33138 -2472 1132060171840 Block: Lot: CHARLES SAMMONS Owner Information Address Phone wow or w CHARLES SAMMONS 600 NE 98 ST MIAMI FL 33138 -2472 Valuation: Total Sq Feet: $ 25,650.00 Contractor(s) Phone Cell Phone DOUBLE DIAMOND CONSTRUCTION I (386)847 -8899 Type of Work: Re Roof Additional Info: ROOFING Classification: Residential Fees Due CCF Education Surcharge Notary Fee Permit Fee - New Roof Scanning Fee Technology Fee Amount $15.60 $5.20 $5.00 $325.00 $15.00 $20.80 Total: $386.60 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. 1 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 construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy May 24, 2010 Pay Date Pay Type Invoice # RF -5 -10 -37916 05/17/2010 Credit Card 05/24/2010 Credit Card Amt Paid Amt Due $ 50.00 $ 336.60 $ 336.60 $ 0.00 Available Inspections: Inspection Type: Up Lift Report Tin Cap Final Roof Tile In Progress Roof Review Roof in Progress Cap Sheet Renailing Affidavit May 24, 2010 Date Cell 1 PRODUCER 05/20/2010 11 :30 9546987157 FRANKCRUM INSURANCE AGENCY, INC. 100 S. MISSOURI AVE. CLEARWATER FL 33756 INSURED FrankCrum 1 -500- 277 -1620 100 S MISSOURI AVENUE CLEARWATER FL 33756 CERTIFICATE HOLDER DOUBLE DIAMOND CONSTRUCTION INC 827 21ST AVENUE NEW SMYRNA BEACH, FL 32169 INSURF$R A. INSURER?; INSURER CI INSURER D: INSU E: CANCELLATION FDXKINKOS 1537 INSURERS AFFORDING COVERAGE FRANK WINSTON CRUM INSURANCE INC. THIS CERTIFICATE I3 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PAGE 02 DATE (Doom) CERTIFICATE OF LIABILITY INSURANCE 12/23/2009 Serial # 152993 NAICA INER ADD% LTR IN$RD A OTHER TYPE OF INSURANCE GENERAL LIABILITY CONR.E=RCIAL GENERAL LIABILITY CLAM MADE OCCUR GEM AGGREGATE LIMB APPLIES PER i 'POLICY [JPRDJECT [1LOG AUTOMOOILE LIABILITY ANY AUTO ALL DWNLb AUTOS SCHEDULED AUTO$ HIRED AUTOS NON -OWNED AUTOS GARAGE UABIt ftY R ANY AUTO I8XCF,$$ / UMBRELLA LIABILITY Dow. ❑CLAIMSMADE R DEoucTisLe RETENTION $ WORRERB COMPENSATION AND SDK-DYERS LIABILITY ANY PROPRIETOR1PARTN$RIEXECUTWE Omc$R 1 MIEMBER ENCLOSED? II sae, da crtha tattler SPECIAL PROVISIONS below POLICY NUMBER WC201000000 • L Y EFFEC DATE (MM/DDM') POLICY EXPI' TION DATE (NMIDD/Yr 01/01/2010 01/01/2011 DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICI $$1 EXCLUSIONS ADDED 13Y ENDORSEMENT/ SPECIAL PROUSEDN$ EFFECTIVE 06/03/2009, COVERAGE IS FOR 100% OF THE EMPLOYEES OF FRANKCRUM LEASED TO PREFERRED ROOFING CONTRACTORS, CORP. (CLIENT) FOR WHOM THE CLIENT IS REPORTING HOURS TO FRANKCRUM. COVERAGE IS NOT EXTENDED TO STATUTORY EMPLOYEES. 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 OF 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 OP SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EIXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL $D DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SHALL IMPOSE NO OBLIGATION OR UABILTIY OP ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE UNITS EACH Q OURRENCE $ �• FIRE DAMAGE Any or* flro) MED EtPP Aro am Daman) _ $ PERSONAL A ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS • COMP/OP AGO $ COMBINED SINGLE LIMIT (En naWdont) $ 9ODILY INJURY (Par mown} $ BODILY EN.IURY (Par naoldant} $ PROPERTYDAMAQIE (Par =Want) $ AUTO ONLY • EA ACCIDENT EA ACC $ $ OTHER THAN ALIT ONLY: AGG $ .• EACH OCCURRENCE $ AGGREGATE $ $ $ $ X WO STATU- TOOK UMPlS I I_ OTHER E.L. MOH ADDIDENT $ 1,000,000 E.L, DISEASE • EA EMPLOYEE $ 1,000,000 $ 1,000,000 $,L, DISEASE - POLICY UNIT PRODUCER 05/20/2010 11 :30 9546987157 FRANKCRUM INSURANCE AGENCY, INC. 100 S. MISSOURI AVE. CLEARWATER FL 33756 INSURED FrankCrum 1 -500- 277 -1620 100 S MISSOURI AVENUE CLEARWATER FL 33756 CERTIFICATE HOLDER DOUBLE DIAMOND CONSTRUCTION INC 827 21ST AVENUE NEW SMYRNA BEACH, FL 32169 INSURF$R A. INSURER?; INSURER CI INSURER D: INSU E: CANCELLATION FDXKINKOS 1537 INSURERS AFFORDING COVERAGE FRANK WINSTON CRUM INSURANCE INC. THIS CERTIFICATE I3 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. PAGE 02 DATE (Doom) CERTIFICATE OF LIABILITY INSURANCE 12/23/2009 Serial # 152993 NAICA INER ADD% LTR IN$RD A OTHER TYPE OF INSURANCE GENERAL LIABILITY CONR.E=RCIAL GENERAL LIABILITY CLAM MADE OCCUR GEM AGGREGATE LIMB APPLIES PER i 'POLICY [JPRDJECT [1LOG AUTOMOOILE LIABILITY ANY AUTO ALL DWNLb AUTOS SCHEDULED AUTO$ HIRED AUTOS NON -OWNED AUTOS GARAGE UABIt ftY R ANY AUTO I8XCF,$$ / UMBRELLA LIABILITY Dow. ❑CLAIMSMADE R DEoucTisLe RETENTION $ WORRERB COMPENSATION AND SDK-DYERS LIABILITY ANY PROPRIETOR1PARTN$RIEXECUTWE Omc$R 1 MIEMBER ENCLOSED? II sae, da crtha tattler SPECIAL PROVISIONS below POLICY NUMBER WC201000000 • L Y EFFEC DATE (MM/DDM') POLICY EXPI' TION DATE (NMIDD/Yr 01/01/2010 01/01/2011 DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICI $$1 EXCLUSIONS ADDED 13Y ENDORSEMENT/ SPECIAL PROUSEDN$ EFFECTIVE 06/03/2009, COVERAGE IS FOR 100% OF THE EMPLOYEES OF FRANKCRUM LEASED TO PREFERRED ROOFING CONTRACTORS, CORP. (CLIENT) FOR WHOM THE CLIENT IS REPORTING HOURS TO FRANKCRUM. COVERAGE IS NOT EXTENDED TO STATUTORY EMPLOYEES. 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 OF 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 OP SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EIXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL $D DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SHALL IMPOSE NO OBLIGATION OR UABILTIY OP ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE STATE OF ROM A, OQ,Utd1'Y Og tADE IHEREBYCERTIFY isa��F � ' ► 4 eft AO 0 7c1 OfTiwicd Sa„ G AL I origin WITNESS artu a � FIAR NOTICE OF A RECORDED COPY MUST BE POSTED PERMIT NO. J - i - 7r 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: 4.,07g 11 0.,✓ l &°d- -K 10/ n'i //fit / ..://198 � - 7 Ortil q M16 1 15 11-- 2. Description of improvement 3. Owner(s) name and address: ,'rnzL.S LG Sil 4 o /v. E etge ST. /�' 1l9 j 7vV'S , FL • T pl Interest in property: Name and address of fee simple titleholder. S/9 E 4. Contractor's name and address: t ��% 0 l 7-4€1 C- i t o• Sr ? / GL t� e, t'. 4 Co O V . 5 r /% L 2, ( 7 5. Surety: (Payment bond required by owner from contractor, if any) Name and Address: Amount of bond $ 6. Lender's name and address: /Yf/d 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes. Name and Address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and Address: /I/o r y 9. Expiration date of this Notice of Commencement (the expiration date is 1 year from the date of recording unless a different date is specified) SUZY Jj aVio Signature of Owner Print Owner's Name Notary Public: Print Notary's Name: My commission expires: COMMENCEMENT C N 20108 13490 x' ON THE JOB SITE AT TIME OF FIRST INSPECTION3R Bk 27295 F's 3163; ( 1 P ) .ECORDED 05/25/2010 09:08:10 ARVEY RUVIFlr CLERK OF COURT IAIII -DARE COUNTY r FLORIDA AST PAGE /1/ iVE TAX FOLIO NO. 11 a - 0 1 7 --1g'P A/ vv R F 2 . A "777e /f/ i. £ P E chin Swom to and subscribed before me this la-" day of /PAY 1111111111111111111111111111111111111111 Prepared by C.,tfQr1es (f. 5 !?(/Y) ( 1101 ,2O f.o BUILDING PERMIT APPLICATION FBC 2004 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) //y ..6 J' d c „\ 0, o AN' Phone # ` DS) ''J' ' 6 7} Owner's Address QO /1 �� 7 f �)7 Cit /?'// / sw—o F4 State / t Tenant/Leessee Name /vv//9' Job Address (where the work is being done) L i /1/a.C. 67 City Miami Shores Ville FOLIO / PARCEL # / / ° - /Pio Is Building Historically Designated YES NO Contractor's Company Name Contractor's Address a City /1/ ...e 4 Qualifier Name State Certificate or Registration No. ' / Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ Type of Work: Describe Work: Bond $ 3 ❑Addition Miami Shores Village Building Department f0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 � State / O> /74..4 ❑Alteration Submittal Fee $ D -Cb Permit Fee $ Notary $ raining/Education Fee $ Scanning $ Radon $ Code Enforcement $ Structural Review. $ County Miami -Dade Zip :New 2 DPBR $ Zip -s J/ Phone # /1 //r Zip Phone # Certificate of Competency No. Double Fee $ Q Technology Fee .$ 0 2 C1 Zoning $ 6 Total Fee Now Due $ Square / Linear Footage Of Work: `36 Permit No. ( P----C" 1 Master Permit No. C Phone # ❑ Repair/Replace ❑ Demolition CCF $ $10� G61CC--- See Reverse side -4 e • z • S 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 CONDMONERS, 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In tj; sence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Signature Owner or Agent Contractor The foregoing instrument was ac ed before me this /.1 The foregoing instrument 1 tr rument was acknowledged before me this c , 20 I®, by n /or e5 E E. �5iv11�1 day of 1 e , 20 6by , day of MAY (who is personally known to m who has produced As identification and wh an oath. NOTARY PUBLIC: 0`lnA.R0 49 * ® •�ossio N F•.� s :,�c 0tco er Re? ho A Z Si *'.. ° m� — �: . : * = Sign: _ V .1 Print: o ; #DD 604136 ; a P rint r. T s m G ., • : "` _ m S My Commission Expires: �,���/ & �, . F � ` ` ` �a My Commissic �\\, ****** * * * * * * * * * *�U�U #+Y+Yf�r*** *fr*** ******WWI r 1 A W XV******** ********************* ** ******Jr�i1rp�rlYitrith*** *it ** *** *drd *** (Revised 07/10/07) APPLICATION APPROVED BY: who is personally known to me or who has producedl_ as ide> iq giAly and who did take an oath. NOTARY ...... h 1 .e• �� . Plans Examiner Engineer Zoning 05/18/2010 14:29 9546987157 PlEaiim IOORNQ contIcTofl$, Re: Roofing Project 730 N.W. 44 Terrace, Deerfield Beach k7 33442 Spite 4203 Cell (754) 3674859 To; The Village of Miami Shores Building Dept. 10050 N.E. 2" Ave Miami Shores F1.33138 Fax: 305.756.8972 Charles Sammoms 600 N. E. 98 st. Miami Shores, El.. 33138 FDXKINKOS 1537 PAGE 02/02 To whom it may concern; Preferred Roofing contractors Inc. will be performing the labor for Double Diamond Inc. at the above referenced address attached is a copy of our workers compensation Insurance made out to Village of Miami. Shores. Cyfthia Stangoni President I L N TR FORD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE INIMMDIYYVY) POLICY EXPIRATION DATE (MWDD/YY):0 UNITS A GENERAL LIABILITY COMMERCIAL GENERAL LRA$RITY GLF00000BB62 -03 2/1/2010 2/1/2011 EACH OCCURRENCE $ 500, 000 X DAMAGE TO RENTED (Eaoc irrance) $ 50,000 , CLAIMS MADE I X I OCCUR _PREMISES MED EXP (Arty one person) $ 5, 000 PERSONAL B ACV INJURY $ 500,000 s 1,000,000 $ 500 000 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLES PER PRODUCTS - COMP/OP AGG POLICY I , ,Tr�T Iri LOC , I AUTOMOBILE LIABIL TY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS E ne SINGLE LIMIT $ BODILY INJURY IPm perm() $ BODILY INJURY (Per eceidenl) $ PROPERTY DAMAGE (Per accident) $ GARAGE UABILITY ANY AUTO AUTO 0NLY- EAACCIDENT $ EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ -- DEDUCTIBLE RETENTION $ $ --j $ I $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? lMandatory In NH) r deambe under SPECIAL PROVISIONS be1w WC - I TORY I STAMTITUS OT ER FI- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT I $ OTHER May 18 2010 8 :53RM The Contractors Choice Rg 866 -758 -9267 IcayR © PRODUCER (800) 918 -3584 FAX: (877) 684 -9951 The Contractors Choice Agency PO Box 13645 Chandler AZ 85248 INSURED Double Diamond Construction Inc 827 East 21st Ave New Smyrna Beach FL 32169 COVERAGES CERTIFICATE OF LIABILITY INSURANCE LE S / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER (305) 756 -8972 Village of Miami Shores 10050 NE 2nd Ave Miami. Shores, FL 33138 ACORD 25(2009/01) INS026 (2011801) HIS 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: Nat 3. Contractors Insurance INSURER B INSURER C: INSURER D: INSURER E: CANCELLATION AUTHORIZED REPRESENTATIVE Robert Rock /BOB p.1 DATE INWDDIYYYY) 5/18/2010 NAIC # 12293 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 CLAI SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OP ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. 0)1988 -2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD May 18 2010 8:53RM The Contractors Choice Rg 868- 758 -9267 p.2 ACORD 25 (2009101) INS025 (zooao1) IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the Issuing Insurer(s), authorized representative or producer, and the certificate holder, nor does It affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. May 18 2010 8:53AM The Contractors Choice Ag 866- 758 -9267 P.3 COMMENTS /REMARKS ENDORSEMENT BLANKET ADDITIONAL INSURED This endorsement changes the policy. Please read it carefully. A. Section II - Who is an insured is amended to include as an additional insured any person cr organization that the "Named Insured" has agreed in a written "insured contract" to name as an additional insured with respect to the general liability coverage provided under this policy. Such person_ or organization is an additional insured provided the "bodily injury" or "property damage" occurs subsequent to the execution of the written "insured contract." Such person or organization is an additional insured only with respect to liability for the "bodily injury" or "property damage" which is caused in whole by the negligence of the "Named Insured" during the policy term in the course of ongoing operations by the "Named Insured" for the additional insured. A person's or organization's status as an additional insured under this endorsement ends when the "Named Insured "'s work or operations for that additional insured are substantially completed or this insurance policy expires, whichever is earliest. The applicable limit of insurance provided under this insurance policy shall not be increased by the inclusion cf any number of additional insureds. The coverage provided for the additional insured is only to the extent the additional insured is held legally liable for the negligence or strict liability of the "Named Insured ". No coverage is provided for liability based upon the acts, errors or omissions of the additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to: 1. "Bodily injury" or "property damage" occurring after all work by the "Named Insured" including materials, parts, cr equipment furnished in connection with such work, (other than service, maintenance or repair) at the site location of the covered operations has been substantially completed. 2. That portion of "your work," out of which the "Bodily Injury" or "Property Damage" arises, that has either been put to its intended use by any person or organization, or is used by another contractor or subcontractor engaged in performing work on the project. This endorsement does not modify the terms and conditions of the insurance policy, including all insuring agreements, except as specifically stated above. GL 00004 Rev 09/08 ENDORSEMENT EXCLUSION - WORK FOR ASSOCIATIONS This endorsement changes the policy. Please read it carefully. It is understood and agreed that this insurance does not apply to any "bodily injury ", "property damage ", "personal injury ", or "advertising injury" that arises out of or is related to an "insured's" or an "insured's" sub - contractors operations or work performed for a Homeowners Association. However, this exclusion does not apply to any operations or work performed for an individual unit owner within a "Homeowners Association" under a written contract between the individual unit owner and the "Named Insured" executed prior to the commencement of the operations or work. Definition: "Homeowners Association" is defined as any residential tract, condominium, planned unit development, townhouse, multiple use residential / commercial or community association, whether or not such community association is a recognized legal entity, where such community association either owns the common areas of the development or is obligated to maintain the common areas of the development and includes any property management firm working for or on behalf of a community association. All other terms and conditions of the policy remain_ unchanged. 0 FREMARK COPYRIGHT 2000, ME SERVICES INC. m:MyFax - Double Diamond To:Update Info for Double Diamond (13057568972) ALEX SINK CHIEF FINANCIAL OFFICER * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: FEIN: BUSINESS NAME AND ADDRESS: DOUBLE DIAMOND CONSTRUCTION INC 827 21ST AVE NEW SMYRNA BEACH FL 32189 SCOPES OF BUSINESS OR TRADE: 1- CERTIFIED ROOFING CONTRACTOR 2- CERTIFIED GENERAL CONTRACTOR IMPORTANT: Pursuant to Chapter 440. 05114), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.0502), F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.05{13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be soblect to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shell revoke a certificate at any time Ioi failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (850) 413-1609 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION 02/17/2010 EXPIRATION DATE: 02/17/2012 COLTUNE PETER J 593824168 11:30 05/18/10GMT -04 Pg 01-03 02-17 -2010 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE: 02/17/2010 EXPIRATION DATE: 02/17/2012 PERSON: PETER d COLTUNE FEIN: 593824188 BUSINESS NAME AND ADDRESS: DOUBLE DIAMOND CONSTRUCTION INC 827 21ST AVE NEW SMYRNA BEACH, FL 32169 SCOPE OF BUSINESS OR TRADE 1- CERTIFIED ROOFING CONTRACTOR 2- CERTIFIED GENERAL CONTRACTOR IMPORTANT 0 Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt.. apply only within the scope of the business or trade listed on R the notice of election to be exempt. E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this Section. QUESTIONS? (850) 413 -1609 * Carry bottom portion on the job, keep upper portion for your records. OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 CUT HERE m:MyFax - Double Diamond To:Update Info for Double Diamond (13057568972) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 COLTUNE, PETER J DOUBLE DIAMOND CONSTRUCTION INC 827 EAST 21ST AVE NEW SMYRNA BEACH FL 32169 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Departments initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE 11:30 05/18/10GMT -04 Pg 02-03 (850) 487 -1395 sTA:i•0FF(Oi AC# :36:8111 49 ` • OF :BUS.I ESS AND l ?ROF$S SIQNAI;..` . REGULATI ON...: CGC007051 p 8 /0 ./08. :087.0 55 CERTIFIED . .GENERAL CONTRACTOR COLTUNL", PETER .J : DOUBLE DIA'AfOND CONSTRUCTION IS CERTIFIED under the provisions of: ch.488 PS. Expiration dates AUG 31, 2010 :LQ8080101168 - -:. The - GENERAI CONT& C TQ impect.4) 1Qw, $•: ``CERT Under :the prov3s:ions Expa,.ration iUTG: • 08•.01 2068 :: AND,:-PROFESSIONAL .REGULATION P I I:CFNSING. SEQ# L08080101168 4IiR :4Y LAW BOB MsKEE LAKE COUNTY TAX COLLECTOR FACILITIES/ MACHINES TYPE OF BUSINESS BUSINESS CONTRACTING 2009/2010 LAKE COUNTY BUSINESS TAX RECEIPT STATE OF FLORIDA ROOMS SEATS EMPLOYEES 2 DOUBLE DIAMOND CONSTRUCTION INC 10708 HIGH CREST CT HOWEY IN THE HILLS, FL 34737 JERRY F CHAPMAN 10708 HIGH CREST CT HOWEY -IN- THE - HILLS, FL 34737 PAID -2009- ?900634 08/25/2009 30.00 ACCT NO. 79146 RECEIPT NO. 8760012106 EXPIRES SEPTEMBER 30, 2010 RENEWAL $30.00 ORIGINAL TAX AMOUNT $30.00 $30.00 TOTAL $30.00 ROOF A SSEMBLIES AND ROOFTOP STRUCTURES b Master Permit No. Process No. Contractor's Name•DO tAck.e. i cr (re .' � Yo ±} s ' W IN " s r o e tQa vl�s 1 .7 ` - c 33 i 3 Job Addres ❑ New Roof Low Slope Roof Area (SF) J Florida Building Code Edition 2004 HIgh- Velocity Hurricane Zone Uniform Permit Application Form. Section A (General Information) ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile o ar/ esive Set Tile Shingles ❑ Asphaltic .___ -, ❑Metal PaneUShingies:_ ,L 1 i S ores \'il ❑ Prescriptive BU��R,� I � gY ROOF TYpBr, , , _ I R eroofing ❑ Recoveri; ❑ Rep � C'G DEPT . I ROOF SYS'IrEmpII INFORMA'tl7t� °J'ECT i 0 COMPLIANCE-WITH ALL FEDERAL ,/' ^' C C.UN 1 Y R ILES A ND Rf_ ffil\ Steep Sloped Roof -Area _(;�. _ _ {mss Sq00 Se 3? s Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and :levels, clearly Identify dimensions of elevated pressure zones and location of parapets. 111111111111111IFIlki,,1 . rs .. .. .. Cl Ime r 1114111111111B1P4P11111C21011110 lik privuurs r 1 i4°0 r Al oi1�Irwiro a■ NmmmmumwAmim 13.32 FLORIDA BUILDING CODE — BUILDING ROOF ASSEMBUES AND ROOFTOP STRUCTURES Florida Building Code-Edition 2004 High- Velocity Hurricane Zone Uniform Penult Application Form. Section C (Low Slope Application) Fill in specific roof assembly components and identify manufacturer (If a component is not used, identify as "NA ") System Manufacturer: � l `./.' k C/' ' A Product Approval No.: 0 2 0(P -D- /0 Design Wind Pressures, From RAS 128 or Calculations: Pmax1: f" Pmax2: 69_ � Pmax3: -/.2-y- 3 Max. Design Pressure, from the s cific Prct Approval system: — / / ° 'F, ' , S7 4 Deck•pe. Woo d ck Gauge/Thickness: Slope: /? Anchor/Base Sheet & No. of Ply(s): - <Alf 1 Anchor/Base Sheet astpngdBon g Material: Insulation Base Layer: MT) Base Insulation Size and Thickness: Base Insulation Fastener/Bonding Material: Top Insulation Layer: Top Insulation Size and Thickness: Top Insulation Fastener/Bonding Material: Base Sheet(s) & No. of Ply(s): Arc g I V ° il C16 e ' Base Sheet Fastener o dine Mat rlaI: Ply Sheet(s) & No. of Ply(s): '- Ply Sheet Fastener/Bonding Material: Top Ply: c � A it Top Ply FastenprB diy • ' in FLORIDA BUILDING CODE — BUILDING 7 ''9 Surfacing: Fastener Spacing for Anchor/Base Sheet Attachment: Field: "' " oc Lap, # Rows 4 @ 6 " oc Perimeter: 6 " oc @ Lap, # Rowsl_ @ " oc Corner: 6 " oc W Lap, # Rows @ " oc Number of Fasteners Per Insulation Board: Field Perimeter 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, Parapet Height, Height of Base Flashing, Component Material, Material Thickness, Fastener Type, Fastener Spacing or Submit P E y • FT. FT. 0 Parapet Height /0 Mean Roof Height (( e, j f - / s/\ V il Pout 3 �I ("Joao/ Corner 15.33 Roof System Manufacturer: Vo' - 14-6/ L LC C . Notice of Acceptance Number: 07- o , 0 Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations_) j _ i o P P2: —? 0 P3: - 9 5 / Maximum Design Pressure (From the Product Approval Specific System): - / ° /2Cc/rti,, /7G ' ROOF ASSEMBUES AND ROOFTOP STRUCTURES 15.34 Ridge Ventilation? Mean Roof Height: .20 Florida Building Code Edition 2004 High - Velocity Hurricane Zone Uniform Permit Application Fonn. Section D (Steep Sloped Roof System) Steep Sloped Roof System Description Deck Type: Type Underlayment: Insulation: Fire Barrier: ,30 S f71 •AQ' r,F d "1 - U v'S Fastener Type & Spacing: Adhesive Type: Type Cap Sheet: Roof Covering: , r / r, / Type & Size Drip Edge: // A cll t o " f i'C 3 X3 /rn 7, fi5 9oc FLORIDA BUILDING CODE — BUILDING Where to Obtain information Description Symbol Where to find Design Pressure P1 or P2 or P3 RAS 127 Table 1 or by an engineerianalysis prepared by PE based on ASCE 7 Mean Roof Height 11 Job Site / Roof Slope . 0 Job Site �y Aerodynamic Multiplier d Product Approval Restoring Moment due to Gravity M g Product App al Attachment Mf Product proval Required Moment Resistance M 6ulated Minimum Attachment Resistance F' Product Approval Required Uplift Resistance Fr C alculated Average Tile Weight W 8 Product Approval Tile Dimensions L = length W = width Product Approval All calculations must be submitted to the building official at the time of permit application. M required Moment Resistance* Mean Roof Height --> Roof Slope J 15' 20' 25' 30' 40' 2:12 34.4 36.5 2 39.7 42.2 3:12 32.2 34.4 36.0 37A 39.8 4:12 30.4 32.2 33.8 35.1 37.3 5:12 28.4 3' 31.6 32.8 34.9 6:12 26.4 ' 28.0 29.4 30.5 32.4 7:12 24.4 25.9 27.1 282 30.0 (P2: (P3: xL xL FLORIDA BUILDING CODE — BUILDING Florida Building Code Edition 2004 High - Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compare the values for M with the values from Mf. If the Mf values are greater than or equal to the M values, for each area of the roof, then the tile attachment method is acceptable. 3 Method 1 "M ent Based Tile Calculations P er RAS 127' 3 = y 0` 7 q� /� (Pt L ' / q - Mg: = M rl Product Approval M f 91 10 343 / -� 6 I � . �/ l 7 (P ) - Mg: �7 = M� Product Approval Mf (P3: `25 ` /x x ® - '1 2 '7`7 _ Mg: f • 9 = r3 °� . t 7 Product Approval Mf Method 2 "Simplified Tile Calculations Per Table Below" Required Moment of Resistance (Mr) From Table Below Product Approval Mf *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F with the values for Fr. If the F values are greater than or equal to the Fr values, for each area of the roof, then the tile attachment method is acceptable. Method 3 "Moment Based Tile Calculations Per RAS 127" xL = xw:= ) -W: xw:= ) - W: xw:= ) - W: x cos 0 x cos 0 x cos 0 = Fri = F,2 = Fr3 ROOF ASSEMBUES AND ROOFTOP STRUCTURES Product Approval F' Product Approval F' Product Approval F' 15.35 M I A M I•DADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) MonierLifetile, LLC 200 Story Road Lake Wales, FL 33853 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 Miami -Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) 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 of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code and the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Barcelona 900 Concrete Roof 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 consists of pages 1 through 6. The submitted documentation was reviewed by Jorge L. Aceb NOA No.: 07- 0220.04 Expiration Date: 04/26/12 Approval Date: 04/26/07 Page 1 of 6 ROOFING ASSEMBLY APPROVAL Category: Sub - Category: Material: SCOPE: This new NOA approves a system using MonierLifetile Barcelona 900 Concrete Roof Tile, as manufactured MonierLifetile LLC and described this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in the installation section herein. The attachment calculations shall be done as a moment based system. PRODUCT DESCRIPTION: Manufactured by Applicant MonierLifetile LLC 1= 17" TAS 112 High profile, interlocking, one - piece, 'S' Barcelona 900 w = 13" shaped, high- pressure extruded concrete roof 1/2' thick tile equipped with three nail holes. For direct deck or battened nail -on, mortar set or adhesive set applications. Trim Pieces SUBMITTED EVIDENCE: Test Agency Redland Technologies Redland Technologies Redland Technologies Redland Technologies Redland Technologies Professional Service Industries, Inc. The Center for Applied Engineering, Inc. Roofing High Profile Roofmg Tiles Concrete Test Dimensions Specifications 1= varies TAS 112 Accessory trim, Boosted Barcelona, concrete w = varies roof pieces for use at hips, rakes, ridges and varying thickness valley terminations. Manufactured for each tile profile. Test Identifier 7161 -03 Appendix III 7161 -03 Appendix 11 PO402 Letter Dated Aug. 1, 1994 P0631 -01 IC- 1320 -94 25- 7688 -3 25- 7688 -10 Product Description Test Name/Report Date Static Uplift Testing Dec. 1991 PA 102 & PA 102(A) Wind Tunnel Testing Dec. 1991 PA 108(Nail -On) Withdrawal Resistance Sept. 1993 Testing of screw vs. smooth shank nails Wind Tunnel Testing Aug. 1994 PA 108 (Nail -On) Wind Tunnel Testing July 1994 PA 108 (Mortar Set) Physical Properties Feb. 1995 PA 112 PA 101 (Adhesive Set) June 1996 PA 101 (Mortar Set) July 1996 NOA No.: 07- 0220.04 Expiration Date: 04/26/12 Approval Date: 04/26/07 Page 2 of 6 ' Test Agency The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Celotex Corporation Testing Services Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Nutting Engineers LINIITATIONS: INSTALLATION: 1. 2. Test Identifier 25- 7688 -5 25- 7688 -4 520111 -3 520191 -2 -1 Calculations Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations 122 Test Name/Report Static Uplift Testing PA 102 (3" Headlap, Nails, Direct Deck, New Construction) Static Uplift Testing PA 102 (4" Headlap, Nails, Clips) Static Uplift Testing PA 101 Aerodynamic Multiplier Two Patty Adhesive Set System 25 -7183 25 -7094 25 -7496 25 -7584 25- 7804b -8 25- 7804 -4 & 5 25- 7848 -6 Restoring Moments Due to Gravity TAS 112 Date June 1996 June 1996 Dec. 1998 March 1999 March 1999 April 1999 March 1995 February 1996 April 1996 December 1996 February 2007 January 2007 1. Fire classification is not part of this acceptance. 2. For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with RAS 106. 3. Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 4. Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 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. 6. This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. MonierLifetile Barcelona 900 Concrete Roof Tile and its components shall be installed in strict compliance with Roofmg Application Standard RAS 118, RAS 119, and RAS 120. Data For Attachment Calculations NOA No.: 07 0220.04 Expiration Date: 04/26/12 Approval Date: 04/26/07 Page 3 of 6 Table 4: Attachment Resistance Expressed as a Moment - M (ft-Ibf) for Nail -On Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19/32" plywood) Battens Barcelona 900 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 Screws 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 Tile Profile 2 ":12" 3 ":12" 4 ":12" 5 ":12" 6 ":12" 7 ":12" greater Battens or Direct Deck Barcelona 900 Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck 7.28 8.13 7.21 8.05 7.10 7.93 6.96 7.78 6.79 7.61 6.61 7.40 Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight -W (Ibf) Length -I (ft) Width -w (ft) MonierLifetile Barcelona 900 11.5 1.417 1.08 Table 2: Aerodynamic Multipliers - A. ft Tile Profile X (ft Batten Application X (ft Direct Deck Application MonierLifetile Barcelona 900 0.289 0.313 Table 3: Restoring Moments due to Gravity - M (ft NOA No.: 07- 0220.04 Expiration Date: 04/26/12 Approval Date: 04/26/07 Page 4 of 6 Table 5: Attachment Resistance Expressed as a Moment M (ft-Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance MonierLifetile Barcelona 900 Adhesive 29.3 1 See manufactures component approval for installation requirements. 2 Dow Chemical TileBond Average weight per patty 10.7 grams. Polyfoam Product, Inc. Average weight per patty 8 grams. Table 5A: Attachment Resistance Expressed as a Moment - Mf (ft -Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance MonierLifetile Barcelona 900 Polyfoam PolyPro 66.5 Polyfoam PolyPro 38.7 3 Large paddy placement of 63grams of PolyProTM'. 4 Medium paddy placement of 24grams of PolyProTM. Table 5B: Attachment Resistance Expressed as a Moment - Mf(ft-Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance MonierLifetile Barcelona 900 Mortar Set' 24.5 5. Tile -Tite Roof Tile Mortar LABELING: All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo, or following statement: "Miami -Dade County Product Control Approved ". MONIERLIFETILE LLC, BARCELONA 900 TILE (LAKE WALES FL PLANT 2) LOCATED UNDERNEATH TILE 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 system. NOA No.: 07- 0220.04 Expiration Date: 04/26/12 Approval Date: 04/26/07 Page 5 of 6 NAIL HOLES PROFILE DRAWING MONIERLIFETILE BARCELONA 900 CONCRETE ROOF TILE END OF THIS ACCEPTANCE NOA No.: 07 -0220.04 Expiration Date: 04/26/12 Approval Date: 04/26/07 Page 6 of 6 M IA M I•DADE N CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Polyglass USA, Inc. 150 Lyon Drive Fernley, NV 89408 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 BCCO (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. BCCO reserves the right to revoke this acceptance, if it is determined by BCCO 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 and the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Polyglass Self - Adhered Roofing Systems Over Wood Decks 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 consists of pages 1 through 23. The submitted documentation was reviewed by Jorge L. Aceb NOA No.: 07- 0822.10 Expiration Date: 10/11/12 Approval Date: 10/11/07 Page 1 of 23 ROOFING ASSEMBLY APPROVAL Category: Sub - Category: Deck Type: Maximum Design Pressure Fire Classification: TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: TABLE 1 Product Elastobase V Elastobase P Elastoflex SA V Vent Elastoflex SA V FR Elastoflex SA V Elastoflex SA P FR Elastoflex SA P Polyflex SA P Polyflex SA P FR Roofmg Modified Bitumen Wood -112.5 psf See General Limitation #1 Test Dimensions Specification 65' 2" x 3' 3 -3/8" ASTM D 4601 5' 2" x 3' 3 -3/8" ASTM D6164 32' 6 "x3' 3 -3/8" ASTM D6163 32' 6" x 3' 3 -3/8" ASTM D 6163 32' 6" x 3' 3 ASTM D 6163 32' 6" x 3' 3 -3/8" ASTM D 6164 32' 6" x 3' 3 -3/8" ASTM D 6164 32' 6" x 3' 3 ASTM D 6222 32' 6" x 3' 3 ASTM D 6222 Product Description SBS modified asphalt coated fiberglass reinforced base sheet. SBS modified asphalt coated polyester reinforced base sheet. Partially self - adhered, fiberglass reinforced, SBS modified bitumen membrane with a self - adhering back face and a smooth top surface. Self - adhered, fiberglass reinforced, SBS modified bitumen membrane with a self - adhering back face and a smooth top surface. Self- adhered, fiberglass reinforced, SBS modified bitumen membrane with a self - adhering back face and a smooth top surface. Self - adhered, polyester reinforced, SBS modified bitumen membrane with a self - adhering back face and a granule top surface. Self - adhered, fiberglass reinforced, SBS modified bitumen membrane with a self - adhering back face and a granule top surface. Self- adhered, polyester reinforced, APP modified bitumen membrane with a self - adhering back face and a granule top surface. Self- adhered, polyester reinforced, APP modified bitumen membrane with a self - adhering back face and a granule top surface. NOA No.: 07- 0822.10 Expiration Date: 10/11/12 Approval Date: 10/11/07 Page 2 of 23 APPROVED INSULATIONS: Product Name Polytherm A l Polytherm Composite ACFoam II ACFoam III High Density Wood Fiberboard Perlite Insulation Type X Gypsum Dens Deck or Dens Deck Prime ENRGY -3 Fesco Board Multi -Max & FA Hunter H- Shield Securock TABLE 2 Product Description Polyisocyanurate foam insulation Polyisocyanurate /perlite composite insulation. Polyisocyanurate foam Insulation Polyisocyanurate foam Insulation Wood fiber insulation board Perlite insulation board Fire resistant rated gypsum. Water resistant gypsum board Polyisocyanurate foam insulation Rigid perlite roof insulation board. Polyisocyanurate roof insulation Polyisocyanurate foam Insulation Fiber reinforced Coverboard Manufacturer (With Current NOA) Polyglass USA, Inc. Polyglass USA, Inc. Atlas Energy Products Atlas Energy Products Generic Generic Generic G -P Gypsum Corp. Johns Manville Johns Manville RMax, Inc. Hunter USG Corp. NOA No.: 07- 0822.10 Expiration Date: 10/11/12 Approval Date: 10/11/07 Page 3 of 23 APPROVED FASTENERS: Fastener Number Product Name 1. Dekfast Fasteners #12, #14 & #15 2. Dekfast Hex Plate 3. Dekfast Lock Plate 4. #12 & #14 Roofgrip 5. Metal Plate 6. Plastic Plate 7. Insul -Fixx HD Fastener 8. Insul -Fixx S 9. Insul -Fixx P 10. Tru -Fast HD 11. Tru -Fast Plates 12. Tru -Fast Plates EVIDENCE SUBMITTED: Test A2encv/Identifier Factory Mutual Research Corp. Exterior Research & Design, LLC Underwriters Laboratories, Inc. Trinity ERD TABLE 3 Product Description Insulation fastener for wood, steel and concrete decks Galvalume hex stress plate. Polypropylene locking plate. Insulation and membrane fastener Galvalume AZ50 stress plate Polyethylene stress plate Insulation fastener for steel and wood decks Galvalume AZ55 stress plate Polyethylene stress plate Insulation fastener for steel and wood decks Galvalume AZ55 steel plate Polyethylene plastic plate Name J.I. 3001334 J.I. 3000857 J.I. 3004091 #11757.12.00 -1 #11757.04.01 -1 #11751.05.03 #11758.08.03 00NK20869 #P1738.02.07 Manufacturer Dimensions (With Current NOA) 2 x 3 ' /a" 3" x 3 '/a" Various 3" square 3.2" round Various 3" round 3" round 3" round 3" round Report FMRC 4470 UL 790 TAS 114 SFS Intec SFS Intec SFS Intec OMG OMG OMG SFS Intec SFS Intec SFS Intec The Tru -Fast Corp. The Tru -Fast Corp. The Tru -Fast Corp. Date 02.15.00 01.12.00 01.12.00 12.07.00 04.25.01 05.30.03 08.11.03 06.08.00 02.05.07 NOA No.: 07- 0822.10 Expiration Date: 10/11/12 Approval Date: 10/11/07 Page 4 of 23 Deck Type 1: Wood, Non - Insulated Deck Description: 19 /32 ° or greater plywood or wood plank, fastened with #8 wood screws at 6" o.c. System Type E(4): Base sheet is mechanically attached to roof deck. All General and System Limitations apply. Base Sheet: Fastening: Ply Sheet: Membrane: Surfacing: One ply of Elastobase V or Elastobase P fastened to the deck as described below: 12 ga. annular ring shanked nails and 1-5/8" tin -caps 6" o.c. in 4" lap and 6" o.c. in four equally spaced staggered rows. Tin -caps are primed with D41 primer. One or more plies of Elastoflex SA V or Elastoflex SA V FR self - adhered. One ply of Elastoflex SA P, Elastoflex SA P FR, Polyflex SA P or Polyflex SA P FR self adhered. (Optional) Install one of the following to obtain required fire classification. 1. Gravel or slag at 400 lbs/sq or 300 lbs /sq, respectively, in a flood coat of approved asphalt at 60 lbs /sq. 2. Karnak 97 Fibrated Aluminum Asphalt Roof Coating or Asbestos Free Aluminum Roof Coating at 11/2 gal/sq. 3. Kokem Products Sunguard Acrylic Roof Coating at 1 gal/sq. 4. Monsey Endure Aluminum Roof Coating, Weather Check or Pro -Grade Aluminum Roof Coating at 11/2 gal/sq. 5. Grundy al MB Aluminum Roof Coating at 1 -2 gal/sq. 6. Fields F350 Heat Shield Aluminum Coating or F630 Heat Shield Fibered Aluminum Coating at 11/2 gal /sq. Maximum Design Pressure: -112.5 psf; (See General limitation #7.). NOA No.: 07- 0822.10 Expiration Date: 10/11/12 Approval Date: 10/11/07 Page 22 of 23 WOOD DECK SYSTEM LIMITATIONS: 1. A slip sheet is required with Ply 4 and Ply 6 when used as a mechanically fastened base or anchor sheet. 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 lbs./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 lbs. /sq. Note: Spot attached systems shall be limited to a maximum design pressure of -45 psf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F') value of 275 lbf., as tested in compliance with Testing Application Standard TAS 105. If the fastener value, as field - tested, are below 275 Ibf insulation attachment shall not be acceptable. 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is based on a minimum fastener resistance value in conjunction with the maximum design value listed within a specific system. Should the fastener resistance be less than that required, as determined by the Buildin, official, a revised fastener spacing, prepared, signed and sealed by a Florida registered Professional Engineer, Registered Architect, or Registered Roof Consultant may be submitted. Said revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in complia;;c:. v, Y11 Roofmg Application Standard RAS 117. 7. Perimeter and corner areas shall comply with the enhanced uplift pressure requirements of these areas. 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 Roofing 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 comers). (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 NOA No.: 07- 0822.10 Expiration Date: 10/11/12 Approval Date: 10/11/07 Page 23 of 23 M I A M I•DADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Polyfoam Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 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 BCCO (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. BCCO reserves the right to revoke this acceptance, if it is determined by BCCO 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 High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Polypro® A11160 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 No.01- 0521.02 and consists of pages 1 through 7 The submitted documentation was reviewed by J rge L. Acebo. NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 1 of ROOFING ASSEMBLY APPROVAL: Category: Sub Category: Materials: SCOPE: This approves Polypro® AH160 as manufactured by Polyfoam Products, Inc. as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does 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 tiles system using Polypro® AH 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift based system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Polypro® AH160 N/A Foampro® RTF1000 N/A ProPack® 30 & 100 N/A PRODUCTS MANUFACTURED BY OTHERS: Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment resistance values with the use of Polypro AH160 roof tile adhesive. PHYSICAL PROPERTIES: Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Closed Cell Content Roofing Roof tile adhesive Polyurethane Test Specifications TAS 101 Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 ASTM D 2856 Product Description Two component polyurethane foam adhesive Dispensing Equipment Dispensing Equipment Results 1.6 lbs./ft.' 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs./Ft 3.1 Perm / Inch +0.07% Volume Change @ -40 F., 2 weeks +6.0% Volume Change @158 100% Humidity, 2 weeks 86% Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variation. NOA No.: 06-0201.02 Expiration Date: 05/10/11 Approval Date: 04/13/06 Page 2 of 7 EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date Center for Applied Engineering #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 Miles Laboratories NB -589 -631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research Institute 01 -6743 -011 ASTM E 108 11/16/94 01- 6739- 062b[1] ASTM E 84 01/16/95 Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 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 LIMITATIONS: 1. Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. 2. Polypro® AH160 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 Polypro® AH160 roof tile adhesive with their tile assemblies shall test in accordance with TAS 101. 5. Roof Tile manufactures acquiring acceptance for the use of HANDI -STICK roof tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. / I F` w \ 2; F= .. MS NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04/13/06 Page 3 of 7 Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (grams) Flat, Low, High Profiles #1 35 N/A High Profile (2 Piece Barrel) #1 17 /side on cap and 34 /pan N/A Flat, Low, High Profiles #2 24 N/A Flat, Low, High Profiles #3 8 INSTALLATION: 1. Polypro® AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® AH160. 2. Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift . based system, to meet or exceed the uplift resistance 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. Polypro® AH160 roof tile adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the Foampro® 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). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 7. Polypro® AH160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AH160 has been dispensed. 9. Polypro® AH160 placement and minimum patty weight shall be in accordance with the Placement Details' herein. Each generic tile profile requires the specific placement noted herein. LABELING: All Polypro® AH160 containers shall comply with the Standard Conditions listed herein. 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.: 06- 0201.02 Expiration Date: 05 /10 /11 Approval Date: 04 /13/06 Page4of7 ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY Optional 2x4's for 1/Place enough adhesive to aniline 1T to 23 square brass In contat with the pan tile steep pItch applications 2) Turn muds upside down. Nate adhesive 112 tn. To 1 tn. From outside edge of cover Ills. Then Install the the. R top portion of the eave sown cover lila Abut to second course of pan Ides. Ensure ewe end of pan and cover Mee are nosh at eave line. Eave closure (matt shown) Nal through plestie cement NOA No.: 06-0201.02 Expiration Date: 05110/11 Approval Date: 04/13/06 Page 5 of 7 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04/13/06 ._ Page 6 of 7 Nall through plastic cement min. t x3 in. Single paddy on under - layment Paddy (between tile) Paddy (under tile) Single paddy on top of file Single paddy under Me Eave course In. X 7 tn. medium size paddy eave Fascle ' course only Nail through plastic cement / i in. x 3 In. Single paddy on undedayment Singly paddy on top of file ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Nall through plastic cemen Underfayment • t' in. x 3 in. Single 4In. paddy on under- layment Single paddy under tile Single paddy between the 2 In. x 7 In. medium size paddy eave course only Single paddy on top of tile Eave Course Fascia Weephole Eave closure Drip edge Eave Course Single paddy between tile Eave Closure 2 in. x 7In. medium Fascisize paddy eave course only a END OF THIS ACCEPTANCE NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 7 of 7